MAGNOLIA GARDENS LLC (NPI# 1891737573) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891737573 |
| Entity Type | Organization |
| Organization Name | MAGNOLIA GARDENS LLC |
| Practice Address |
6710 Mallery Dr Lanham MD 20706-3964 |
| Practice Telephone | 3015522000 |
| Mailing Telephone | 3015522000 |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2018-06-21 |
| Authorized Official Name | MICHAEL T. BERG (ASSISTANT SECRETARY) |
| Authorized Official Telephone | 5054684752 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 235Z00000X | Speech-Language Pathologist | 16011 | MD | Speech, Language and Hearing Service Providers |
| Y | 314000000X | Skilled Nursing Facility | 16-011 | MD | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AMERIGROUP | 08952 | 01 | |
| CAREFIRST PROV/INQ# | 028F | 01 | |
| AENTA-HMO | 0529622 | 01 | |
| MD | 818989700 | 05 | |
| UNITED - MAMSI | 345178 | 01 | |
| CAREFIRST BLUECHOICE | HV1 | 01 | |
| UNITED - AMERICHOICE | 7100074 | 01 | |
| CAREFIRST IND/PPO | HV1 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518483239 | Magnolia Gardens LLC | Skilled Nursing Facility | 6710 Mallery Dr, Lanham, MD 20706-3964 | 2017-08-15 |
| 1346699071 | Magnolia Gardens LLC | Occupational Therapist | 6710 Mallery Dr, Lanham, MD 20706-3964 | 2016-06-03 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | MAGNOLIA GARDENS LLC | 1865 Palmer Avenue, Larchmont, NY 10538 |
| Indiana Business Entities | MAGNOLIA GARDENS LLC | 5705 West 45th Avenue, Gary, IN 46408 |
| Street Address |
6710 MALLERY DR |
| City | LANHAM |
| State | MD |
| Zip Code | 20706-3964 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538778717 | Rosemary Idowu | Nurse Practitioner | 6710 Mallery Dr, Lanham, MD 20706-3964 | 2020-07-23 |
| 1831737675 | Jeanine Spurley | Occupational Therapy Assistant | 6710 Mallery Dr, Lanham, MD 20706-3964 | 2019-12-11 |
| 1467005884 | Adalia Cubie | Physical Therapy Assistant | 6710 Mallery Dr, Lanham, MD 20706-3964 | 2019-07-24 |
| 1518483239 | Magnolia Gardens LLC | Skilled Nursing Facility | 6710 Mallery Dr, Lanham, MD 20706-3964 | 2017-08-15 |
| 1285183426 | Donna Opeikun | Occupational Therapist | 6710 Mallery Dr, Lanham, MD 20706-3964 | 2016-09-29 |
| 1346699071 | Magnolia Gardens LLC | Occupational Therapist | 6710 Mallery Dr, Lanham, MD 20706-3964 | 2016-06-03 |
| 1093170441 | Donald Smith | Physical Therapy Assistant | 6710 Mallery Dr, Lanham, MD 20706-3964 | 2015-12-29 |
| 1881065282 | Ashlie N Williams | Physical Therapist | 6710 Mallery Dr, Lanham, MD 20706 | 2015-10-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760046775 | Ayesha Tappin | Occupational Therapist | 4200 Parliament Pl. Ste 550, Lanham, MD 20706 | 2019-04-24 |
| 1790240646 | Himabindu Gangavarapu Vinodrao | Nurse Practitioner | 8118, Good Luck Road, Lanhham, MD 20706 | 2019-02-05 |
| 1538644943 | Win Team, LLC | Clinic/Center | 10001 Derekwood Lane, Suite 210, Lanham, MD 20706 | 2018-10-02 |
| 1558846394 | Brieana Moore | Behavioral Analyst | 4551 Parliament Place Suite A, Lanham, MD 20706 | 2018-09-27 |
| 1225511553 | Melvis Afanwi Chi | Home Health Aide | 9861 Goodluck Rd, T1, Lanham, MD 20706 | 2018-09-12 |
| 1346722766 | Elsie Clarke | Nurse Practitioner | 9470 Annapolis Road Suite 311, Lanham, MD 20706 | 2018-09-01 |
| 1821576141 | Amie Da Silva | Nurse Practitioner | 5724 Edge Avenue, Lanham, MD 20706 | 2018-07-30 |
| 1033697313 | Iyadunni Omolara Olukorede | Home Health Aide | 9789 Good Luck Rd Apt 9, Lanham, MD 20706 | 2018-07-30 |
| 1447741459 | A Step Ahead Preventive and Holistic Wellness Center LLC | Psychologist | 4500 Forbes Blvd # 200-w12, Lanham, MD 20706 | 2018-05-24 |
| 1902394398 | Ezekiel Kelechukwu Nwafor | Home Health Aide | 5447 85th Ave Apt 202, Lanham, MD 20706 | 2018-05-01 |
| Find all providers in zip 20706 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942349386 | Mayflower Choice Care Inc. | Skilled Nursing Facility | 9418 Annapolis Rd, Suite 106, Lanham, MD 20706-3023 | 2007-02-05 |
| 1518483239 | Magnolia Gardens LLC | Skilled Nursing Facility | 6710 Mallery Dr, Lanham, MD 20706-3964 | 2017-08-15 |
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| 1073042479 | The Lions Center for Rehabilitation and Extended Care, Inc. | Skilled Nursing Facility | 901 Seton Drive, Cumberland, MD 21502 | 2017-06-08 |
| 1518493774 | Bea's Hive Assisted Living | Skilled Nursing Facility | 3014 Nightside Drive, Upper Marlboro, MD 20774 | 2017-05-10 |
| 1417490277 | Grace Compassionate Health Care | Skilled Nursing Facility | 113 River Forest Ln, Ft Washington, MD 20744-6240 | 2016-11-28 |
| 1447705967 | Sarah Lorraine Bensinger | Skilled Nursing Facility | 9 N Summit Dr Apt 202, Gaithersburg, MD 20877-3056 | 2016-08-25 |
| 1578927489 | 1046 North Point, LLC | Skilled Nursing Facility | 1046 North Point Rd, Baltimore, MD 21224-3307 | 2016-04-06 |
| 1578927588 | Pineview Extended Care Centre, Inc. | Skilled Nursing Facility | 9016 Pine View Lane, Clinton, MD 20735-3229 | 2016-04-06 |
| 1861851321 | The Lutheran Village At Miller's Grant, Inc. | Skilled Nursing Facility | 9000 Fathers Legacy, Ellicott City, MD 21042 | 2016-02-12 |
| 1881063154 | Supplemental Health | Skilled Nursing Facility | 1292 Limit Ave, Idlewylde, MD 21239-1747 | 2015-09-17 |
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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.