BALUM IMAGING LLC (NPI# 1063886612) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063886612 |
| Entity Type | Organization |
| Organization Name | BALUM IMAGING LLC |
| Practice Address |
5500 Knoll North Dr Suite 190 Columbia MD 21045-2370 |
| Practice Telephone | 4439172700 |
| Practice Fax Number | 4104151418 |
| Mailing Telephone | 4439172700 |
| Mailing Fax Number | 4104151418 |
| Enumeration Date | 2015-11-19 |
| Last Update Date | 2015-11-19 |
| Authorized Official Name | MATTHEW SCOTT DEHAVEN (CEO) |
| Authorized Official Telephone | 4439172700 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0200X |
Clinic/Center Specialization: Radiology |
M478 | MD | Ambulatory Health Care Facilities |
| Street Address |
5500 KNOLL NORTH DR SUITE 190 |
| City | COLUMBIA |
| State | MD |
| Zip Code | 21045-2370 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487650891 | Shanita Chase | Family Medicine | 5500 Knoll North Dr, Suite 370, Columbia, MD 21045-2209 | 2005-06-22 |
| 1023621174 | Wendy Strong | Nurse Practitioner | 5500 Knoll North Dr, Columbia, MD 21045-2370 | 2020-08-28 |
| 1386209302 | Nasseri Clinic of Arthritic & Rheumatic Diseases, LLC | Internal Medicine | 5500 Knoll North Dr, Columbia, MD 21045-2370 | 2019-05-06 |
| 1255807228 | Amber Bokhari | Student in an Organized Health Care Education/Training Program | 5500 Knoll North Dr, Columbia, MD 21045-2370 | 2018-10-17 |
| 1164971644 | Lauren Heather Saks | Social Worker | 5500 Knoll North Dr, Suite 370, Columbia, MD 21045-2370 | 2016-09-26 |
| 1033560438 | Lisa M Alley | Specialist/Technologist | 5500 Knoll North Dr, Columbia, MD 21045-2370 | 2016-06-27 |
| 1245684547 | One World Healthcare LLC | Internal Medicine | 5500 Knoll North Dr, Suite 220, Columbia, MD 21045-2370 | 2016-04-22 |
| 1598127391 | Glen Burnie Physical Therapy & Sportscare, LLC | Occupational Therapist | 5500 Knoll North Dr, Ste 150, Columbia, MD 21045 | 2016-03-22 |
| 1700245552 | Maria Loreto Miranda Bravo | Counselor | 5500 Knoll North Dr, 370, Columbia, MD 21045-2370 | 2016-02-22 |
| 1457717480 | Kimberly Mcgeady | Audiologist | 5500 Knoll North Dr, Suite 320, Columbia, MD 21045-2370 | 2016-01-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497374136 | Keenan Eldridge | Behavior Technician | 8950 Md-108, Suite 100, Columbia, MD 21045 | 2020-04-13 |
| 1730724220 | Luci Lee Redman Cassella | Family Medicine | 8900 Columbia 100 Parway Suite G, Columbia, MD 21045 | 2019-11-08 |
| 1417519414 | Howard County Health Department | Clinic/Center | Cradlerock Elementary School-based Wellness Center, 6700 Cradlerock Way, Columbia, MD 21045 | 2019-07-01 |
| 1649754490 | Dana Pirzchalski | Behavioral Analyst | 8815 Columbia Parkwary, 4, Columbia, MD 21045 | 2018-09-18 |
| 1871089177 | Melissa Jo Kennedy | Behavior Technician | 8815 Columbia Parkway, 4, Columbia, MD 21045 | 2018-07-10 |
| 1497246193 | Kjd | Physical Therapist | 8900 Columbia 100 Pkwy Ste C, Columbia, MD 21045 | 2018-05-29 |
| 1174010276 | Roger Lee | Audiologist | 8600 Snowden River Pkwy #309, Columbia, MD 21045 | 2018-04-16 |
| 1811497910 | Dominique Nichole Hale | Behavior Technician | 8115 Columbia 100 Parkway, Suite 4, Columbia, MD 21045 | 2018-02-15 |
| 1982116802 | Bradley D. Stiles | Acupuncturist | 6257 Deep River Cyn, Columbia, MD 21045 | 2017-11-01 |
| 1194234849 | University of Maryland Eye Associates, P.a. | Eyewear Supplier (Equipment, not the service) | 5900 Waterloo Road, Suite 230, Columbia, MD 21045 | 2017-09-26 |
| Find all providers in zip 21045 | ||||
| Taxonomy Code | 261QR0200X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Radiology |
| Definition to come... |
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| 1750688453 | First Imaging Center Inc | Clinic/Center | 8860 Columbia 100 Pkwy Suite 10, Columbia, MD 21045-2195 | 2011-02-16 |
| 1104889377 | Inmed Diagnostics Services of S C L L C | Clinic/Center | 126 S Assembly St, Columbia, SC 29201-4545 | 2006-04-10 |
| 1710948047 | Laurel Imaging Center, LLC | Clinic/Center | 2750 Laurel St, Suite 104, Columbia, SC 29204-2038 | 2006-03-28 |
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| 1710088075 | Metropolitan Radiology Associates Chartered | Clinic/Center | 3327 Superior Lane, Suite 103, Bowie, MD 20715 | 2006-09-26 |
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| 1427071604 | Affiliated Pet Systems LLC | Clinic/Center | 1400 Forest Glen Rd Ste 430, Silver Spring, MD 20910-1464 | 2006-07-26 |
| 1447283536 | Vymed Diagnostic Imamaging/salisbury LLC | Clinic/Center | 200 B East Vine Street, Salisbury, MD 21804 | 2006-07-09 |
| 1598702870 | Open Mri & Imaging Center of Elkton,llc | Clinic/Center | 301 Augustine Herman Hwy, Ste A, Elkton, MD 21921-6587 | 2006-06-02 |
| 1780636928 | Advanced Medical Solutions, LLC | Clinic/Center | 8200 Professional Pl, Suite 115, Hyattsville, MD 20785-2212 | 2006-05-16 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.