Organization Active NPI

Emros Behavioral Healthcare Services LLC

  • Psychiatry Physician
  • Bel Air, MD
National Provider Identifier
1992327068
Registry record updated May 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
EMROS BEHAVIORAL HEALTHCARE SERVICES LLC
Practice address
700 Henderson Rd
Bel Air, MD 21014-2515
Phone
(443) 655-9931
Fax
(410) 638-1912
NPI assigned
May 12, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2020

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

Authorized official

Name
Emil Kwabla Fiasorgbor, NPNPI 1659831808
Title
Psychiatric Nurse Practitoner
Phone
(443) 655-9931

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0800X Primary

Addresses

Primary practice location

700 Henderson Rd
Bel Air, MD 21014-2515

Mailing address

700 Henderson Rd
Bel Air, MD 21014-2515
Phone (443) 655-9931

Other identifiers 1

IdentifierTypeStateIssuer
791275MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200527000731 MD Part B Supplier - Clinic/Group Practice 4385065549 Receives reassigned benefits from 1 practitioner
Practice locations: Essex, MD

National Provider Directory

National Provider Directory

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": "1589241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589241600000",
    "number": "1992327068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 HENDERSON RD",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210142515",
            "telephone_number": "443-655-9931",
            "fax_number": "410-638-1912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 HENDERSON RD",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210142515",
            "telephone_number": "443-655-9931",
            "fax_number": "410-638-1912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMROS BEHAVIORAL HEALTHCARE SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-12",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A",
        "authorized_official_last_name": "FIASORGBOR",
        "authorized_official_first_name": "EMIL",
        "authorized_official_middle_name": "KWABLA",
        "authorized_official_title_or_position": "PSYCHIATRIC NURSE PRACTITONER",
        "authorized_official_telephone_number": "443-655-9931",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "791275",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bel Air, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2020; 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.