OPTIMUM FAMILY CLINIC (NPI# 1336624113) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336624113 |
| Entity Type | Organization |
| Organization Name | OPTIMUM FAMILY CLINIC |
| Other Organization Name | OPTIMUM FAMILY CLINIC LLC |
| Practice Address |
6014 Harford Rd Baltimore MD 21214-1327 |
| Practice Telephone | 4439856011 |
| Practice Fax Number | 8665961084 |
| Mailing Telephone | 4439856011 |
| Mailing Fax Number | 8665961084 |
| Enumeration Date | 2018-09-27 |
| Last Update Date | 2019-09-26 |
| Authorized Official Name | MISS BLESSING GABRIEL (PROVIDER) |
| Authorized Official Telephone | 7034361823 |
| Authorized Official Credential | CRNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | MARYLAND LICENSE | R198392 | 01 |
| Other Name | Type Code |
|---|---|
| Optimum Family Clinic LLC | Former Legal Business Name - Organization |
| Street Address |
6014 HARFORD RD |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21214-1327 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811544034 | Emani Williams | Behavior Technician | 4606 Walker Avenue, Baltimore, MD 21214 | 2019-08-22 |
| 1457831166 | Smith Podiatry & Associates LLC | Clinic/Center | 5610 Harford Rd Ste A, Baltimore, MD 21214 | 2018-08-21 |
| 1013435387 | Marcus Motton | Clinic/Center | 5629 Harford Road, Baltimore, MD 21214 | 2017-09-06 |
| 1528432143 | Beverly Jean Tellis | Social Worker | 6310 Harford Road, Baltimore, MD 21214 | 2015-11-19 |
| 1972848745 | Amy M Young | Occupational Therapist | 5908 Edna Ave, Baltimore, MD 21214 | 2012-12-05 |
| 1306112693 | The Good Samaritan Hospital of Maryland, Inc. | Clinic/Center | 4700 Hartford Road, Baltimore, MD 21214 | 2012-03-30 |
| 1578731824 | Rebecca Michele Green | Speech-Language Pathologist | 5302 Plymouth Road, Baltimore, MD 21214 | 2008-02-20 |
| 1891975918 | Karen Schmidt | Occupational Therapist | 604 Hartford Rd., Baltimore, MD 21214 | 2007-11-06 |
| 1972790533 | Patricia Mary Marchetti Smith | Speech-Language Pathologist | 2709 Woodsdale Avenue, Baltimore, MD 21214 | 2007-09-27 |
| 1780896290 | Scott David Hubert | Dentist | 5810 Harford Rd, Baltimore, MD 21214 | 2007-05-04 |
| Find all providers in zip 21214 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598364192 | Folasade O Onasanya | Nurse Practitioner | 3312 Croydon Rd, Baltimore, MD 21207-4543 | 2020-10-23 |
| 1437785706 | Hajia M Nagaiya | Nurse Practitioner | 3525 Courtleigh Dr, Baltimore, MD 21244-2205 | 2020-03-19 |
| 1730654062 | Alaina Lourdes Frey | Nurse Practitioner | 3455 Wilkens Ave # L10, Baltimore, MD 21229-5213 | 2018-10-13 |
| 1538687140 | E & T Healthcare Enterprise | Nurse Practitioner | 8113 Hartford Road, Baltimore, MD 21234 | 2017-09-04 |
| 1447791058 | Elizabeth Richmond | Nurse Practitioner | 2 East Wells Apt 179, Baltimore, MD 21230 | 2017-03-15 |
| 1073050365 | Marla Brown | Nurse Practitioner | 6821 Reisterstown Rd Ste 106, Baltimore, MD 21215-1434 | 2017-01-24 |
| 1326443086 | Yury Malachevsky | Nurse Practitioner | 2435 W. Belvedere Avenue, Suite 22, Baltimore, MD 21215 | 2014-10-23 |
| 1174954499 | Neighborhood Wellness, LLC | Nurse Practitioner | 2401 Liberty Heights Avenue, Mondawmin Mall, Space 4625, Baltimore, MD 21215-8086 | 2013-12-12 |
| 1811261050 | Ashley Miller Salamone | Nurse Practitioner | 1800 Orleans Street Sheikh Zayed Tower, Suite 7125 F-1, Baltimore, MD 21287-0020 | 2012-03-06 |
| 1467445924 | Shannon K Idzik | Nurse Practitioner | 655 W Lombard St, 345, Baltimore, MD 21201-1512 | 2005-08-30 |
| Find all providers in BALTIMORE | ||||
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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.