Active NPI
Billie Shabazz
- Social Worker
- Baltimore, MD
National Provider Identifier
1912449992
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 22128
- Practice address
- 421 Fallsway
Baltimore, MD 21202-4800 - Phone
- (443) 703-1365
- NPI assigned
- Nov 8, 2016
- Last updated
- Nov 8, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 22128 | MD | Primary |
Addresses
Primary practice location
421 Fallsway
Baltimore, MD 21202-4800
Mailing address
421 Fallsway
Baltimore, MD 21202-4800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 383841200 | Medicaid | MD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22128 | MD | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pearl Therapy & Wellness | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Community/Behavioral Health Agency
- Baltimore, MD
- NPI 1639828023
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1478563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478563200000",
"number": "1912449992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "421 FALLSWAY",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212024800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "421 FALLSWAY",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212024800",
"telephone_number": "443-703-1365"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHABAZZ",
"first_name": "BILLIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-11-08",
"last_updated": "2016-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MD",
"license": "22128",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "383841200",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.