Odoemenam Benneth Uzoma

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X

License

DD0405 Issued in MD

Practice address

1232 Race Rd Ste 101
Rosedale, MD 21237-2362

Phone

(410) 448-0500

Fax

(443) 836-4343

NPI assigned

Nov 15, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1636934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1962168872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1232 RACE RD STE 101",
            "city": "ROSEDALE",
            "state": "MD",
            "postal_code": "212372362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1232 RACE RD STE 101",
            "city": "ROSEDALE",
            "state": "MD",
            "postal_code": "212372362",
            "telephone_number": "410-448-0500",
            "fax_number": "443-836-4343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UZOMA",
        "first_name": "ODOEMENAM",
        "middle_name": "BENNETH",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-11-15",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "MD",
            "license": "DD0405",
            "primary": true
        },
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MD",
            "license": "DD0405",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• University of Maryland Specialty Care Network LLC
• University of Maryland Specialty Care Network LLC
• University of Maryland St. Joseph Medical Group, LLC (University of Maryland St. Joseph Medical Group)
• University of Maryland St. Joseph Medical Group, LLC (University of Maryland St. Joseph Medical Group)
• University of Maryland St. Joseph Orthopaedics, LLC
• Cynthia Vanauken, CRNA
• Stephanie Vancek Castro, LCSWC
• Jillian Vanlandeghem
• Camille Vanleer, LMSW
• Vaughan Home Care Services,Inc

• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Rosedale, MD
• Providers in Rosedale, MD by specialty
• Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; 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.