KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC.


Address: 1221 Mercantile Ln, Largo, MD 20774-5374
Phone: 3016185500

KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. (NPI# 1346888427) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1346888427
Entity Type Organization
Organization Name KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC.
Practice Address 1221 Mercantile Ln
Largo
MD 20774-5374
Practice Telephone 3016185500
Mailing Telephone 3016185500
Enumeration Date 2019-12-19
Last Update Date 2019-12-19
Authorized Official Name MR. JOSEPH T BUTZ (CHIEF OPERATING OFFICER)
Authorized Official Telephone 3018165867
Is Organization Subpart Y
Parent Organization Name KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC.

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QH0100X Clinic/Center
Specialization: Health Service 		Ambulatory Health Care Facilities

Other Provider/Organization Names

Other Name Type Code
Largo Medical Center DPP Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1316574833 Kaiser Foundation Health Plan of The Mid-atlantic States, Inc. Clinic/Center 4400 Forbes Blvd, Lanham, MD 20706-4447 2020-03-25
1215058326 Kaiser Foundation Health Plan of The Mid-atlantic States, Inc. Health Maintenance Organization 12255 Fair Oaks Pkwy, Fairfax, VA 22033-3952 2007-04-03
1285752121 Kaiser Foundation Health Plan of The Mid-atlantic States, Inc. Health Maintenance Organization 7670 Quarterfield Rd, Glen Burnie, MD 21061-3947 2007-03-27
1417075318 Kaiser Foundation Health Plan of The Mid-atlantic States, Inc. Health Maintenance Organization 7190 Crestwood Boulevard, Frederick, MD 21703-7314 2007-03-27
1699833202 Kaiser Foundation Health Plan of The Mid-atlantic States, Inc. Clinical Medical Laboratory 6625 Belcrest Highway, Hyattsville, MD 20782-2003 2006-12-05
1285272369 Kaiser Foundation Health Plan of The Mid-atlantic States, Inc. Clinic/Center 700 2nd St Ne, Washington, DC 20002-8100 2019-12-19
1457999542 Kaiser Foundation Health Plan of The Mid-atlantic States, Inc. Clinic/Center 4920 Campbell Blvd, Baltimore, MD 21236-5916 2019-12-19
1689212763 Kaiser Foundation Health Plan of The Mid-atlantic States, Inc. Clinic/Center 201 N Washington St, Falls Church, VA 22046-4518 2019-12-19
1659919744 Kaiser Foundation Health Plan of The Mid-atlantic States, Inc. Clinic/Center 6501 Loisdale Ct, Springfield, VA 22150-1826 2019-12-19
1710525803 Kaiser Foundation Health Plan of The Mid-atlantic States, Inc. Clinic/Center 14139 Potomac Mills Rd, Woodbridge, VA 22192-4644 2019-12-19

Other Data Sources

Entity Type Entity Name Entity Address
Washington State Corporations KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. 1 Kaiser Plz, Oakland, CA 94612-3610

Office Location

Street Address 1221 MERCANTILE LN
City LARGO
State MD
Zip Code 20774-5374

Providers in the same location

NPI Name Taxonomy Address Enumeration
1164425419 Stephen J Ilario Orthopaedic Surgery 1221 Mercantile Ln, Largo, MD 20774-5374 2005-05-31
1780215020 Malika Tamara Haylock-jones Nurse Practitioner 1221 Mercantile Ln, Largo, MD 20774-5374 2020-01-27
1164069449 Ashasha Tselat Sumbatyan Physical Therapy Assistant 1221 Mercantile Ln, Largo, MD 20774-5374 2019-12-05
1598316184 Deepa L Cruz Registered Nurse 1221 Mercantile Ln, Largo, MD 20774-5374 2019-09-25
1639720204 Charmaine Andra Mckie Registered Nurse 1221 Mercantile Ln, Largo, MD 20774-5374 2019-09-25
1669028338 Shanelle Moore Family Medicine 1221 Mercantile Ln, Largo, MD 20774-5374 2019-08-17
1356815112 Nanah Hannah Sevalie Nurse Practitioner 1221 Mercantile Ln, Largo, MD 20774-5374 2019-01-15
1215436183 Shadana Maddox Pharmacist 1221 Mercantile Ln, Largo, MD 20774-5374 2018-02-06
1336650878 Kyla Trenay Scott Registered Nurse 1221 Mercantile Ln, Largo, MD 20774-5374 2017-10-23
1235667270 Onyekachukwu Ada Ihezie Pharmacist 1221 Mercantile Ln, Largo, MD 20774-5374 2017-06-02
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1922637156 Marie Charlotte Teboutsou Tsodzou Nurse Practitioner 9317 Lavall Drive, Upper Marlboro, MD 20774 2020-04-08
1467093443 Richland Support Services Corp. Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities 11551 Joyceton Drive, Upper Marlboro, MD 20774 2019-10-01
1770134124 Alan L Kahn Counselor 301 Largo Rd., Largo, MD 20774 2019-09-26
1619522034 Francisca Ifeoma Alintah Registered Nurse 511 Dennis Magruder Dr., Upper Marlboro, MD 20774 2019-08-02
1609337146 Crystal Osuchukwu Counselor 1300 Mccormick Dr, Upper Marlboro, MD 20774 2019-03-27
1861968489 Collaborative Concepts of Maryland Counselor 1400 Mercantile Lane, Suite 208, Largo, MD 20774 2018-10-22
1073097622 Triple Angels Homecare Services, Inc. In Home Supportive Care 1210 Dixie Bowie Way, Upper Marlboro, MD 20774 2018-09-19
1922589654 Optimum Resource Services, LLC Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 711 Harry S. Truman Dr, Unit #105, Largo, MD 20774 2018-08-21
1811475254 Kolawole Richard Olatunde Home Health Aide 11405 Villa Court, Upper Marlboro, MD 20774 2018-07-28
1548747769 Tiara Williams Counselor 15207 Harriet Clotilda Way, Upper Marlboro, MD 20774 2018-07-20
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Taxonomy Information

Taxonomy Code 261QH0100X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Health Service

Taxonomy Definition

Definition to come...
Notes: [7/1/2006: modified title]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1558670158 James P. Beard D.c.p.a. Clinic/Center 1920 W Bay Dr Ste 1, Largo, FL 33770-3022 2010-09-29

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1114526696 Alive & Well Company Clinic/Center 400 Warfield Dr, Hyattsville, MD 20785-4584 2020-10-26
1487252714 Restore Healthcare Services Clinic/Center 15017 Northcote Ln, Bowie, MD 20716-1044 2020-10-09
1932712254 Covenant Cosmetic & Wellness Center Clinic/Center 3415 Hamilton Street, Suite 5, Hyattsville, MD 20782 2020-08-26
1679191290 Ez Health Resources, LLC Clinic/Center 13119 Piney Meetinghouse Rd, Potomac, MD 20854-6350 2020-07-09
1962027052 Tammy Senn, LLC Clinic/Center 2996 Hobbs Rd, Glenwood, MD 21738-9731 2020-06-15
1548885346 Doris Collaborative Family Practice, LLC Clinic/Center 7671 Mandrake Ct Unit 222, Elkridge, MD 21075-7995 2020-06-08
1205457124 Mark Johnson, Md, PC Clinic/Center 10801 Lockwood Dr Ste 285, Silver Spring, MD 20901-1556 2020-05-01
1548894314 Isinc Healthcare Services, LLC Clinic/Center 229 Washington Blvd S, Laurel, MD 20707-4615 2020-03-02
1821648312 Capital Multi Health Group, Inc Clinic/Center 2411 Crofton Ln Ste 4a, Crofton, MD 21114-1337 2019-09-17
1396395166 Farr Out Eyecare LLC Clinic/Center 820 Market St, Westminster, MD 21157-6114 2019-09-13
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Competitor

Search similar providers

City LARGO
Zip Code 20774

Improve Information

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Dataset Information

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.

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