NORTHWEST HOSPITAL CENTER, INC (NPI# 1447354790) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447354790 |
| Entity Type | Organization |
| Organization Name | NORTHWEST HOSPITAL CENTER, INC |
| Other Organization Name | NORTHWEST WOUND CLINIC |
| Practice Address |
5401 Old Court Rd Randallstown MD 21133-5103 |
| Mailing Address |
5401 Old Court Rd Attn: Credentialing Randallstown MD 21133-5103 |
| Practice Telephone | 4105212200 |
| Mailing Telephone | 4106015524 |
| Mailing Fax Number | 4106018946 |
| Enumeration Date | 2006-09-08 |
| Last Update Date | 2017-06-23 |
| Authorized Official Name | MR. KEVIN KELBLY (CFO) |
| Authorized Official Telephone | 4108716861 |
| Is Organization Subpart | Y |
| Parent Organization Name | NORTHWEST HOSPITAL CENTER, INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | 03-004 | MD | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | R/R MEDICARE GROUP # | CN6601 | 01 |
| Other Name | Type Code |
|---|---|
| Northwest Wound Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437255734 | Northwest Hospital Center, Inc | Physician Assistant | 5401 Old Court Rd, Randallstown, MD 21133-5103 | 2006-09-15 |
| 1508961988 | Northwest Hospital Center, Inc | Internal Medicine | 5401 Old Court Rd, Randallstown, MD 21133-5103 | 2006-09-13 |
| 1982708228 | Northwest Hospital Center, Inc | Surgery | 5401 Old Court Rd, Randallstown, MD 21133-5103 | 2006-09-08 |
| 1467462028 | Northwest Hospital Center, Inc | Physician Assistant | 5401 Old Court Rd, Randallstown, MD 21133-5103 | 2006-08-08 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | NORTHWEST HOSPITAL CENTER, INC. | 5401 Old Court Rd, Randallstown, MD 21133-5103 |
| Street Address |
5401 OLD COURT RD |
| City | RANDALLSTOWN |
| State | MD |
| Zip Code | 21133-5103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427054089 | Michael Holloway | Specialist | 5401 Old Court Rd, Randallstown, MD 21133-5103 | 2005-06-28 |
| 1235746231 | Brianne Elizabeth Leaf | Surgery | 5401 Old Court Rd, Randallstown, MD 21133-5103 | 2020-09-24 |
| 1528674132 | April Puskar | Nurse Practitioner | 5401 Old Court Rd, Randallstown, MD 21133-5103 | 2020-09-18 |
| 1790398659 | Jessica Stehman | Physician Assistant | 5401 Old Court Rd, Randallstown, MD 21133-5103 | 2020-08-28 |
| 1578176863 | Margot Wallace | Physician Assistant | 5401 Old Court Rd, Randallstown, MD 21133-5103 | 2020-08-26 |
| 1740805779 | Elizabeth M Atkinson | Physician Assistant | 5401 Old Court Rd, Randallstown, MD 21133-5103 | 2020-06-16 |
| 1316571722 | Morgan Ariel Murray | Nurse Practitioner | 5401 Old Court Rd, Randallstown, MD 21133-5103 | 2020-02-24 |
| 1811527278 | Ifeoma Jennifer Dunn | Nurse Practitioner | 5401 Old Court Rd, Randallstown, MD 21133-5103 | 2020-01-23 |
| 1598395725 | Ayodeji Bamidele Olawale | Nurse Practitioner | 5401 Old Court Rd, Randallstown, MD 21133-5103 | 2020-01-15 |
| 1336779578 | Lerin Jackson | Nurse Practitioner | 5401 Old Court Rd, Randallstown, MD 21133-5103 | 2020-01-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649898313 | Olivia David | Registered Nurse | 3525 Liberty Resource Drive, Randallstown, MD 21133 | 2020-07-09 |
| 1366082547 | Jerry Njomgert Christopher | Home Health Aide | 9106 Sandra Ct. Randallstown, Randallstown, MD 21133 | 2020-01-15 |
| 1487138913 | For Hope's Sake, LLC | Substance Abuse Rehabilitation Facility | 9905 Southhall Road, Randallstown, MD 21133 | 2018-09-20 |
| 1295214393 | Levindale Hebrew Geriatric Center & Hospital Inc | Clinic/Center | Lifebridge Health Adult Day Services, 5400 Old Court Road, Randallstown, MD 21133 | 2018-08-09 |
| 1235623968 | Away of Change Counseling Service, LLC | Counselor | 5310 Old Court Rd Ste 304, Randallstown, MD 21133 | 2018-06-16 |
| 1922503382 | Top Care Residential Inc | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 8607 Liberty Rd, Randallstown, MD 21133 | 2018-03-28 |
| 1497274880 | Yushika M Shepherd | In Home Supportive Care | 8911 Allenswood Rd, Randallstown, MD 21133 | 2017-09-17 |
| 1790208718 | Productive Lives Mental Health, LLC | Clinic/Center | Randallstown Medical Center 5310 Old Court Rd Suite 308, Randallstown, MD 21133 | 2017-07-21 |
| 1982136198 | Marla Rosanne Yee | Dentist | 5415 Old Court Road, Suite 01, Randallstown, MD 21133 | 2017-03-28 |
| 1598203549 | Traci Harris | Social Worker | 9633 Liberty Rd. (suites H&j), Randallstown, MD 21133 | 2017-02-09 |
| Find all providers in zip 21133 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619332475 | John Dylan Luck | Surgery | 5401 Old Court Rd Dept Of, Randallstown, MD 21133-5103 | 2015-12-22 |
| 1235746231 | Brianne Elizabeth Leaf | Surgery | 5401 Old Court Rd, Randallstown, MD 21133-5103 | 2020-09-24 |
| 1831695444 | Ahmad Zeineddin | Surgery | 5401 Old Court Rd, Randallstown, MD 21133-5103 | 2018-04-03 |
| 1336684505 | Lifebridge Community Physicians, Inc. | Surgery | 5401 Old Court Rd, Randallstown, MD 21133-5103 | 2016-12-27 |
| 1942652458 | Olubode Olufajo | Surgery | 5401 Old Court Rd, Randallstown, MD 21133-5103 | 2016-07-08 |
| 1962865014 | Franca Kraenzlin | Surgery | 5401 Old Court Rd, Randallstown, MD 21133-5103 | 2016-04-05 |
| 1205221504 | Latoya Silverton | Surgery | 5401 Old Court Rd, Randallstown, MD 21133-5103 | 2015-04-02 |
| 1487048237 | Russell Becker | Surgery | 5401 Old Court Rd, Randallstown, MD 21133-5103 | 2015-03-18 |
| 1962891564 | Nicholas Calotta | Surgery | 5401 Old Court Rd, Randallstown, MD 21133-5103 | 2015-01-20 |
| 1053739185 | Ian Angus Powelson | Surgery | 5401 Old Court Rd, Randallstown, MD 21133-5103 | 2014-04-05 |
| Find all providers in RANDALLSTOWN | ||||
| City | RANDALLSTOWN |
| Zip Code | 21133 |
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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.