NPIMap

Organization Active NPI

Phoenix Rising LLC

  • Home Health Agency
  • Baltimore, MD
National Provider Identifier
1972736221
Registry record updated Sep 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
R2759 Issued in MD
Legal business name
PHOENIX RISING LLC
Practice address
3106 E Northern Pkwy
Baltimore, MD 21214-1420
Phone
(410) 444-9999
Fax
(410) 444-9995
NPI assigned
Sep 2, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2009

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

Authorized official

Name
Kwame Tanner
Title
Owner
Phone
(443) 315-6152

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X R2759 MD Primary

Addresses

Primary practice location

3106 E Northern Pkwy
Baltimore, MD 21214-1420

Mailing address

3106 E Northern Pkwy
Baltimore, MD 21214-1420
Phone (410) 444-9999

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1251849600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251849600000",
    "number": "1972736221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3106 E NORTHERN PKWY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212141420",
            "telephone_number": "410-444-9999",
            "fax_number": "410-444-9995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3106 E NORTHERN PKWY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212141420",
            "telephone_number": "410-444-9999",
            "fax_number": "410-444-9995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX RISING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-02",
        "last_updated": "2009-09-02",
        "status": "A",
        "authorized_official_last_name": "TANNER",
        "authorized_official_first_name": "KWAME",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-315-6152"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "MD",
            "license": "R2759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Sep 2, 2009; 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.