NPIMap

Organization Active NPI

Sheppard Pratt Health System, Inc

  • Psychiatric Hospital
  • Elkridge, MD
National Provider Identifier
1932269495
Registry record updated Jun 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric HospitalTaxonomy code 283Q00000X
License
13-002 Issued in MD
Legal business name
SHEPPARD PRATT HEALTH SYSTEM, INC
Practice address
7220 Discovery Drive
Elkridge, MD 21075
Phone
(410) 938-3000
NPI assigned
Dec 12, 2006
Organization subpart
Yes
Parent organization
SHEPPARD PRATT HEALTH SYSTEM, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 18, 2021

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

Authorized official

Name
Martha Jane Scanlan
Title
Director, Patient Fiscal Services
Phone
(410) 938-5046

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital 283Q00000X 13-002 MD Primary

Addresses

Primary practice location

7220 Discovery Drive
Elkridge, MD 21075

Mailing address

6501 N Charles St
Baltimore, MD 21204-6819
Phone (410) 938-3000

Other practice location 1

4100 College Ave
Ellicott City, MD 21043-5506
Phone (410) 938-3000 ext. 3150

Other identifiers 1

IdentifierTypeStateIssuer
165800002MedicaidMD

Other names 1

  • Sheppard Pratt - Baltimore/Washington Campus Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071204000299 MD Part A Provider - Hospital 6608965322 7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ellicott City, MD; Baltimore, MD; Elkridge, MD

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1932269495. Details of each certification follow.

Hospital certification: CCN 214000

Legal name
SHEPPARD PRATT HEALTH SYSTEM, INC.
Doing business as
SHEPPARD PRATT HOSPITAL AND SHEPPARD AND ENOCH AND PRATT HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Psychiatric
Participating since
Jul 1, 1966
Last certification
Jun 23, 2011
Beds
322
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 1853 in MD
Enrollment address
6501 N Charles St
Sheppard Pratt Hospital
Baltimore, MD 21204-6819
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Sheppard and Enoch Pratt Hospital, theCCN 214000 · All quality measures
Type
Psychiatric
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory
Tax ID family
Gatonsville Day Hospita26 organizations share this tax ID, including this one
Part of
Gatonsville Day Hospita

Other organizations with this tax ID 25

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

View all 25

Locations

4100 College Ave
Ellicott City, MD 21043
Phone (410) 465-3322

Ownership & related parties

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Harsh Trivedi Individual Corporate OfficerPresident and Ceo Jul 1, 2016
Joshua Kakel Individual Corporate DirectorChair, Board Member Feb 7, 2017
Kelly Savoca Individual Corporate OfficerVice President & Cfo Jul 1, 2019
Operational/Managerial ControlVice President & Cfo Jul 1, 2019
Collin Mothupi Individual Corporate DirectorVice Chair, Board Member Mar 15, 2018
Susan Kessler Individual Corporate DirectorDirector, Revenue Cycle Jan 11, 2021
W-2 Managing EmployeeDirector Revenue Cycle Jan 11, 2021
Operational/Managerial ControlDirector Revenue Cycle Jan 11, 2021

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623974400000",
    "number": "1932269495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6501 N CHARLES ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212046819",
            "telephone_number": "410-938-3000",
            "fax_number": "410-938-3159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7220 DISCOVERY DRIVE",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "21075",
            "telephone_number": "410-938-3000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4100 College Ave",
            "address_purpose": "LOCATION",
            "city": "Ellicott City",
            "state": "MD",
            "postal_code": "210435506",
            "country_code": "US",
            "telephone_number": "410-938-3000 x3150",
            "fax_number": "410-938-3159",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SHEPPARD PRATT HEALTH SYSTEM, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SHEPPARD PRATT HEALTH SYSTEM, INC",
        "enumeration_date": "2006-12-12",
        "last_updated": "2021-06-18",
        "certification_date": "2021-06-18",
        "status": "A",
        "authorized_official_last_name": "SCANLAN",
        "authorized_official_first_name": "MARTHA",
        "authorized_official_middle_name": "JANE",
        "authorized_official_title_or_position": "DIRECTOR, PATIENT FISCAL SERVICES",
        "authorized_official_telephone_number": "410-938-5046"
    },
    "taxonomies": [
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": "MD",
            "license": "13-002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "165800002",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sheppard Pratt - Baltimore/Washington Campus",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Sheppard Pratt - Baltimore/Washington Campus",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Elkridge, MD

Sources for this page

Verify at the official NPI Registry.