COPPIN STATE UNIVERSITY (NPI# 1427244706) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427244706 |
| Entity Type | Organization |
| Organization Name | COPPIN STATE UNIVERSITY |
| Other Organization Name | CSU COMMUNITY HEALTH CENTER |
| Practice Address |
2500 W North Ave Suite 131 Baltimore MD 21216-3633 |
| Mailing Address |
2601 W. North Avenue Suite 131 Baltimore MD 21216 |
| Practice Telephone | 4109514188 |
| Mailing Telephone | 4109514188 |
| Mailing Fax Number | 4109516158 |
| Enumeration Date | 2007-09-19 |
| Last Update Date | 2013-02-22 |
| Authorized Official Name | MRS. SHAVON T. LEGETTE (ASSOCIATE DIRECTOR) |
| Authorized Official Telephone | 4109514188 |
| Authorized Official Credential | CRNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities | ||
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
MD | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 216500700 | 05 | |
| MD | 216200700 | 05 |
| Other Name | Type Code |
|---|---|
| CSU Community Health Center | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | COPPIN STATE UNIVERSITY | 2500 W North Ave, Baltimore, MD 21216-3633 |
| Street Address |
2500 W NORTH AVE SUITE 131 |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21216-3633 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275538050 | Yvonne Marie Moragne-coon | Nurse Practitioner | 2500 W North Ave, Baltimore, MD 21216-3633 | 2005-06-17 |
| 1740747260 | Jose Hernandez Hallmen | Social Worker | 2500 W North Ave, Baltimore, MD 21216-3633 | 2019-02-21 |
| 1861932485 | Aisha Russell | Specialist/Technologist | 2500 W North Ave, Pec 131, Baltimore, MD 21216-3633 | 2017-03-01 |
| 1619424785 | Tracey Murray | Nurse Practitioner | 2500 W North Ave, Baltimore, MD 21216-3633 | 2016-09-07 |
| 1134525850 | Joan Tilghman | Nurse Practitioner | 2500 W North Ave, Baltimore, MD 21216-3633 | 2014-11-06 |
| 1538489588 | Virletta C. Bryant | Social Worker | 2500 W North Ave, Baltimore, MD 21216-3633 | 2010-06-01 |
| 1689990749 | Alisa Davis | Registered Nurse | 2500 W North Ave, Baltimore, MD 21216-3633 | 2010-04-14 |
| 1104819267 | Dionne Mebane-raley | Nurse Practitioner | 2500 W North Ave, Grace Jacobs Building 818, Baltimore, MD 21216-3633 | 2005-08-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083279343 | Matanmi Olusesan Kuforiji | Social Worker | 2300 Garrison Boulevard Suite 101, Baltimore, MD 21216 | 2019-05-02 |
| 1003389602 | Michelle Antoinette Goines | Social Worker | 1522 N Ellamont St, Baltimore, MD 21216 | 2019-01-07 |
| 1780178764 | Lifespring Laboratories | Clinical Medical Laboratory | 2200 Garrison Blvd Ste 3013, Baltimore, MD 21216 | 2018-06-21 |
| 1467980896 | Patricia Ann Harriott | Counselor | 3312alto Rd., Baltimore, MD 21216 | 2017-05-30 |
| 1538549209 | Baltimore Podiatry Group, Dr. Benjamin Kleinman, P.a. | Durable Medical Equipment & Medical Supplies | 2300 Garrison Blvd., Suite 105, Baltimore, MD 21216 | 2015-06-08 |
| 1649461500 | Issac Corrette Evans Jr. | Adult Companion | 2810 Harlem Ave, Baltimore, MD 21216 | 2007-08-06 |
| 1396824959 | Linda S Miles | Dentist | 4155 Patterson Ave, Baltimore, MD 21216 | 2006-11-03 |
| 1902913197 | Miriam W Ingram | Nurse Practitioner | 3102 N Hilton Street, Baltimore, MD 21216 | 2006-08-24 |
| 1326065905 | Linda P Weisburger | Nurse Practitioner | 2001 N Warwick Ave, Baltimore, MD 21216 | 2006-07-17 |
| 1972502680 | Shavon Trenice Darden | Nurse Practitioner | 2601 W North Ave, Hhsb Suite 131, Baltimore, MD 21216 | 2005-07-15 |
| Find all providers in zip 21216 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
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|---|---|---|---|---|
| 1407476955 | Rcc Community Services, Inc | Clinic/Center | 2628 Harford Rd, Baltimore, MD 21218-4928 | 2020-04-24 |
| 1164926085 | Redeem Healthcare and Medical System Inc | Clinic/Center | 3240 Belair Rd Fl 1, Baltimore, MD 21213 | 2018-03-23 |
| 1669983904 | Pricare Medical Center LLC | Clinic/Center | 8113 Harford Rd Ste 100, Baltimore, MD 21234-5790 | 2017-10-13 |
| 1720597420 | Margaret Temitayo Owolabi | Clinic/Center | 5513 York Rd, Baltimore, MD 21212-3804 | 2017-09-25 |
| 1467714618 | Community Care Center Corporation | Clinic/Center | 1216 E Baltimore St, Attn: Community Care Center, Baltimore, MD 21202-4710 | 2012-06-13 |
| 1033716329 | Divine Care Family Practice, LLC | Clinic/Center | 6018 Harford Rd, Baltimore, MD 21214-1327 | 2020-10-08 |
| 1821628801 | Familycare Nurse Practitioner LLC | Clinic/Center | 2300 Garrison Blvd Ste 100, Baltimore, MD 21216-2308 | 2020-01-19 |
| 1902448335 | Jade Health & Wellness, LLC | Clinic/Center | 3301 Belair Rd, Baltimore, MD 21213-1257 | 2019-10-17 |
| 1871154278 | Clinic Management and Development Services, Inc. | Clinic/Center | 1850 N Milton Ave, Baltimore, MD 21213-2549 | 2019-06-26 |
| 1760941041 | North Point Medical Group, LLC | Clinic/Center | 2805 N Point Rd, Baltimore, MD 21222-2413 | 2019-03-18 |
| 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.