Powell Recovery Center, Inc.

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

POWELL RECOVERY CENTER, INC.

Practice address

16 S Broadway
Baltimore, MD 21231-1712

Phone

(410) 276-1773

NPI assigned

Nov 9, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Kim Krantz Wireman, LCSW-C, LGADC

Title

President/Ceo

Phone

(410) 276-1773

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

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

• Powell Recovery Center, Inc.

  • Adult Mental Health Clinic/Center
  • Baltimore, MD
  • NPI 1699928994

  O20070910000225

  Same enrollment

Practitioners 2

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

• Paul Thomas Barbera Jr., M.D.

  • Internal Medicine Physician
  • Sparrows Point, MD
  • NPI 1053459487
  NPD (past)
• Paulette Camille Hill, MD

  • Addiction Medicine (Family Medicine) Physician
  • Baltimore, MD
  • NPI 1619054046
  NPD (past)

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

{
    "created_epoch": "1131494400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633651200000",
    "number": "1952382665",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 S BROADWAY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212311712",
            "telephone_number": "410-276-1773",
            "fax_number": "410-276-2056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 S BROADWAY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212311712",
            "telephone_number": "410-276-1773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POWELL RECOVERY CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-09",
        "last_updated": "2021-10-08",
        "certification_date": "2021-10-08",
        "status": "A",
        "authorized_official_last_name": "WIREMAN",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "KRANTZ",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "410-276-1773",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW-C, LGADC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "MD",
            "license": "103079",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "218121500",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "415783400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Powell Recovery Center, Inc.
• Powell Recovery Center, Inc.
• Powell Recovery Center, Inc.
• Powell Recovery Center, Inc.
• Powell Recovery Center, Inc.
• Powell Recovery Center, Inc.
• Powell Recovery Institute
• Shajaira Powell-Bailey
• Brittani Powell
• Brittany Powell

• Mental Health Clinic/Center (Including Community Mental Health Center) in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.