NPIMap

Organization Active NPI

House of the Good Shepherd Corporation

  • Local Education Agency (LEA)
  • Baltimore, MD
National Provider Identifier
1942570353
Registry record updated Jan 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Local Education Agency (LEA)Taxonomy code 251300000X
Legal business name
HOUSE OF THE GOOD SHEPHERD CORPORATION
Practice address
4100 Maple Ave
Baltimore, MD 21227-4007
Phone
(410) 247-2770
NPI assigned
Jan 3, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2012

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

Authorized official

Name
Dr. Derrick Boone
Title
Ceo
Phone
(410) 247-2770

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Local Education Agency (LEA) 251300000X Primary

Addresses

Primary practice location

4100 Maple Ave
Baltimore, MD 21227-4007

Mailing address

4100 Maple Ave
Baltimore, MD 21227-4007
Phone (410) 247-2770

Other identifiers 1

IdentifierTypeStateIssuer
427825900MedicaidMD

Other names 1

  • Good Shepherd School Other name

National Provider Directory

National Provider Directory
Tax ID family
Good Shepherd School2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

4100 Maple Ave
Baltimore, MD 21227
Phone (410) 247-2770

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1325548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1325548800000",
    "number": "1942570353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4100 MAPLE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212274007",
            "telephone_number": "410-247-2770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 MAPLE AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212274007",
            "telephone_number": "410-247-2770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOUSE OF THE GOOD SHEPHERD CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-03",
        "last_updated": "2012-01-03",
        "status": "A",
        "authorized_official_last_name": "BOONE",
        "authorized_official_first_name": "DERRICK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "410-247-2770",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "427825900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Good Shepherd School",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2012; 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.