NPIMap

Organization Active NPI

Luminis Health Medical Group, LLC

  • Behavior Analyst
  • Annapolis, MD
National Provider Identifier
1922477256
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Legal business name
LUMINIS HEALTH MEDICAL GROUP, LLC
Practice address
2635 Riva Rd
Annapolis, MD 21401-7430
Phone
(443) 481-6549
Fax
(443) 481-6515
NPI assigned
Sep 16, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2021

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

Authorized official

Name
Peter Odenwald
Title
Vice President
Phone
(443) 481-6415

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X Primary

Addresses

Primary practice location

2635 Riva Rd
Annapolis, MD 21401-7430

Mailing address

PO Box 12622
Belfast, ME 04915
Phone (443) 481-6549

Other names 1

  • Anne Arundel Medical Group Behavioral Health Specialists Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Anne Arundel Phys Group LLC221 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 22

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1442361600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621814400000",
    "number": "1922477256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12622",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "04915",
            "telephone_number": "443-481-6549",
            "fax_number": "443-481-6515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2635 RIVA RD",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017430",
            "telephone_number": "443-481-6549",
            "fax_number": "443-481-6515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUMINIS HEALTH MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-16",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A",
        "authorized_official_last_name": "ODENWALD",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "443-481-6415"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anne Arundel Medical Group Behavioral Health Specialists",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Anne Arundel Medical Group Behavioral Health Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.