GREATER BADEN MEDICAL SERVICE INCORPORATED (NPI# 1417107913) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417107913 |
| Entity Type | Organization |
| Organization Name | GREATER BADEN MEDICAL SERVICE INCORPORATED |
| Other Organization Name | GREATER BADEN MEDICAL SERVICE AT LA PLATA |
| Practice Address |
6 Garrett Ave La Plata MD 20646-5959 |
| Mailing Address |
7450 Albert Rd 3rd Floor Brandywine MD 20613-3035 |
| Practice Telephone | 3015395100 |
| Practice Fax Number | 3015395105 |
| Mailing Telephone | 3015990460 |
| Mailing Fax Number | 3015992174 |
| Enumeration Date | 2008-09-22 |
| Last Update Date | 2014-02-25 |
| Authorized Official Name | COLENTHIA A MALLOY (CHIEF EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 3015990460 |
| Is Organization Subpart | Y |
| Parent Organization Name | GREATER BADEN MEDICAL SERVICE INCORPORATED |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 911431900 | 05 |
| Other Name | Type Code |
|---|---|
| GREATER BADEN MEDICAL SERVICE AT LA PLATA | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093987729 | Greater Baden Medical Service Incorporated | Clinic/Center | 1442 Addison Rd S, Capitol Heights, MD 20743-4413 | 2008-04-02 |
| 1659541746 | Greater Baden Medical Service Incorporated | Clinic/Center | 3028 Brightseat Rd, Suite 104, Glenarden, MD 20706-1438 | 2008-03-05 |
| 1477073773 | Greater Baden Medical Service Incorporated | Dentist | 1458 Addison Rd S, Capitol Heights, MD 20743-4413 | 2017-06-27 |
| 1669992814 | Greater Baden Medical Service Incorporated | Dentist | 6196 Oxon Hill Rd Ste 540, Oxon Hill, MD 20745-3112 | 2017-06-20 |
| 1083950521 | Greater Baden Medical Service Incorporated | Clinic/Center | 6196 Oxon Hill Rd, Suite 540, Oxon Hill, MD 20745-3100 | 2013-01-02 |
| 1700036183 | Greater Baden Medical Service Incorporated | Clinic/Center | 13605 Baden Westwood Rd, Brandywine, MD 20613-8422 | 2008-09-23 |
| 1275783615 | Greater Baden Medical Service Incorporated | Clinic/Center | 1458 Addison Rd S, Capitol Heights, MD 20743-4413 | 2008-09-23 |
| 1922258367 | Greater Baden Medical Service Incorporated | Clinic/Center | 23140 Moakley St, #4, Leonardtown, MD 20650-2930 | 2008-09-23 |
| 1912927344 | Greater Baden Medical Service Incorporated | Clinic/Center | 7450 Albert Rd, 3rd Floor, Brandywine, MD 20613-8422 | 2006-07-20 |
| Street Address |
6 GARRETT AVE |
| City | LA PLATA |
| State | MD |
| Zip Code | 20646-5959 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932718822 | Charles Regional Surgical Center LLC | Clinic/Center | 5 North Laplata Court, 2nd Floor, Laplata, MD 20646 | 2020-07-27 |
| 1902387988 | Sheldon Villarta | Physical Therapist | 10200 La Plata Town, La Plata, MD 20646 | 2018-08-27 |
| 1912485244 | Kelli Hill Goldsborough | Nurse Practitioner | 5 N La Plata Ct Ste 101, La Plata, MD 20646 | 2018-07-30 |
| 1083128490 | Charles County Rescue Squad Inc | Ambulance | 2 Calvert St, La Plata, MD 20646 | 2017-11-21 |
| 1801261532 | Catherine Deshetler | Social Worker | 5 N Maple Ave Ste 206, La Plata, MD 20646 | 2015-12-07 |
| 1215346481 | Brittany Godin | Speech-Language Pathologist | 5 Garrett Avenue, La Plata, MD 20646 | 2014-08-12 |
| 1558787606 | Homeplace Assisted Living | Assisted Living Facility | 10210 La Plata Rd, La Plata, MD 20646 | 2014-03-13 |
| 1891056628 | Godfrey T Hewitt | Dentist | 6620 Crain Hwy #204, Laplata, MD 20646 | 2012-06-07 |
| 1740573823 | Armida Bondoc Gonzales | Physical Therapist | 15 S Maple Ave, Apt 2, La Plata, MD 20646 | 2011-05-23 |
| 1023315348 | Charity E Dugan | Surgery | Um Charles Regional Medical Group, 5 North La Plata Court Ste 103, La Plata, MP 20646 | 2011-02-23 |
| Find all providers in zip 20646 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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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.