Immanuel Van Slyke Joseph, RN

Primary specialty

General Practice Registered NurseTaxonomy code 163WG0000X

License

R180947 Issued in MD

Practice address

8811 Sumner Grove Dr
Laurel, MD 20708-3533

Phone

(240) 355-3266

NPI assigned

Dec 4, 2023

Last updated

Dec 4, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1701648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1932975638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8811 SUMNER GROVE DR",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207083533",
            "telephone_number": "240-355-3266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8811 SUMNER GROVE DR",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207083533",
            "telephone_number": "240-355-3266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSEPH",
        "first_name": "IMMANUEL",
        "middle_name": "VAN SLYKE",
        "name_prefix": "Mr.",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-12-04",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "MD",
            "license": "R180947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Jordan
• Dianna Jordan, LCSW-C, LCSW, MSW
• Joseph a. Maravi, LLC
• Afrilasia Joseph-Phipps, MSW
• Elizabeth Joseph
• Jubi Joseph
• Sally D Joseph
• Tomy N/a Joseph
• Cholet Kelly Josue, M.D.
• Journey Care Services

• General Practice Registered Nurse in Laurel, MD
• Providers in Laurel, MD by specialty
• General Practice Registered Nurse in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2023; 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.