Prosperity Tree International Healthcare Services

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

PROSPERITY TREE INTERNATIONAL HEALTHCARE SERVICES

Practice address

1440 N Bond St
Baltimore, MD 21213-2903

Phone

(443) 204-5641

NPI assigned

Apr 22, 2024

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Duwayne Smith, NPNPI 1427833276

Title

Owner

Phone

(443) 204-5641

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Duwayne F Smith

  • Psychiatric/Mental Health Nurse Practitioner
  • Baltimore, MD
  • NPI 1427833276
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1713744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713744000000",
    "number": "1902651037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 N BOND ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212132903",
            "telephone_number": "443-204-5641"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 N BOND ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212132903",
            "telephone_number": "443-204-5641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSPERITY TREE INTERNATIONAL HEALTHCARE SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-22",
        "last_updated": "2024-04-22",
        "certification_date": "2024-04-22",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "DUWAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-204-5641",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Psychiatric/Mental Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.