Organization Active NPI

Randallstown Health Care LLC

  • Speech-Language Pathologist
  • Randallstown, MD
National Provider Identifier
1922548502
Registry record updated Mar 2, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
RANDALLSTOWN HEALTH CARE LLC
Practice address
4511 Robosson Rd
Randallstown, MD 21133-1018
Phone
(410) 922-2443
NPI assigned
Mar 2, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2017

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

Authorized official

Name
Kevin Goedeke
Title
President
Phone
(410) 922-2443

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

4511 Robosson Rd
Randallstown, MD 21133-1018

Mailing address

4511 Robosson Rd
Randallstown, MD 21133-1018

Other identifiers 1

IdentifierTypeStateIssuer
600112200MedicaidMD

Other names 1

  • Chapel Hill Nursing Center Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1488412800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1488412800000",
    "number": "1922548502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4511 ROBOSSON RD",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211331018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4511 ROBOSSON RD",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211331018",
            "telephone_number": "410-922-2443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDALLSTOWN HEALTH CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-02",
        "last_updated": "2017-03-02",
        "status": "A",
        "authorized_official_last_name": "GOEDEKE",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-922-2443"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "600112200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chapel Hill Nursing Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Randallstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2017; 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.