NPIMap

Organization Active NPI

Baltimore Medical System, Inc

  • Federally Qualified Health Center (FQHC)
  • Rosedale, MD
National Provider Identifier
1922004720
Registry record updated Sep 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
BALTIMORE MEDICAL SYSTEM, INC
Doing business as
Baltimore Medical System Inc
Practice address
9520 Philadelphia Rd
Rosedale, MD 21237-4106
Phone
(410) 558-4700
NPI assigned
Jun 27, 2005
Reactivated
Jun 1, 2023
Last updated
Sep 2, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2025

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

Authorized official

Name
Shirley Sutton
Title
President and Ceo
Phone
(410) 558-4891

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

9520 Philadelphia Rd
Rosedale, MD 21237-4106

Mailing address

5525 Eastern Ave Ste 301
Baltimore, MD 21224-2796
Phone (410) 732-8800

Other identifiers 2

IdentifierTypeStateIssuer
376751500MedicaidMD
376751508MedicaidMD

Other names 1

  • Baltimore Medical System Inc Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040122000181 MD Part A Provider - Federally Qualified Health Center (FQHC) 5395653455 Practice locations: Rosedale, MD

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1922004720. Details of each certification follow.

Federally qualified health center certification: CCN 211822

Legal name
BALTIMORE MEDICAL SYSTEM, INC.
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Oct 15, 1998
Last certification
Oct 15, 1998
Ownership / control type
For profit – partnership
Organization structure
CorporationNon-profit
Incorporated
Jul 1, 1985 in MD
Enrollment address
9520 Philadelphia Rd
Rosedale, MD 21237-4106
Related CCNs
211810

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Baltimore Medical System Inc24 organizations share this tax ID, including this one

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

Ownership & related parties

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Allison Mackenzie Individual Corporate OfficerBoard Member Jul 27, 2015
Lisa L Holly Individual W-2 Managing EmployeeInsurance Credentialing Specialist Jun 1, 2016
Yolanda Copeland Individual Corporate OfficerBoard Member Dec 19, 2016
Christopher Demarco Individual Corporate OfficerBoard Member Jan 1, 2008
Cheryl Bryant Individual Corporate OfficerBoard Member Aug 24, 2015
Margaret Boemmel Individual Corporate OfficerCfo Dec 16, 2019
W-2 Managing EmployeeCfo Dec 16, 2019
Scarlett Watson Individual Corporate OfficerBoard Member May 1, 2015
Michael Banfield Individual Corporate OfficerBoard Member Jan 23, 2017
Arif Khan Individual Corporate OfficerBoard Member Dec 19, 2016
Christina McWilliams Individual Corporate OfficerBoard Member Aug 24, 2015

NPI Registry JSON

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756771200000",
    "number": "1922004720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5525 EASTERN AVE STE 301",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212242796",
            "telephone_number": "410-732-8800",
            "fax_number": "410-327-1693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9520 PHILADELPHIA RD",
            "city": "ROSEDALE",
            "state": "MD",
            "postal_code": "212374106",
            "telephone_number": "410-558-4700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALTIMORE MEDICAL SYSTEM, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-27",
        "last_updated": "2025-09-02",
        "certification_date": "2024-02-02",
        "deactivation_date": "2023-05-13",
        "reactivation_date": "2023-06-01",
        "status": "A",
        "authorized_official_last_name": "SUTTON",
        "authorized_official_first_name": "SHIRLEY",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "410-558-4891"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "376751500",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "376751508",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baltimore Medical System Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rosedale, MD

Sources for this page

Verify at the official NPI Registry.