DR. JACK LAURENCE WAPNER (NPI# 1164688677) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1164688677 |
Entity Type | Individual |
Full Name | DR. JACK LAURENCE WAPNER |
Credential | M.D. |
Practice Address |
11100 Liberty Rd Suite F Randallstown MD 21133-1026 |
Practice Telephone | 4106552740 |
Practice Fax Number | 4106554740 |
Mailing Telephone | 4106552740 |
Mailing Fax Number | 4106554740 |
Enumeration Date | 2008-08-04 |
Last Update Date | 2008-08-04 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2084A0401X |
Psychiatry & Neurology Specialization: Addiction Medicine |
D0026048 | MD | Allopathic & Osteopathic Physicians |
Street Address |
11100 LIBERTY RD SUITE F |
City | RANDALLSTOWN |
State | MD |
Zip Code | 21133-1026 |
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 | 2084A0401X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Psychiatry & Neurology |
Specialization | Addiction Medicine |
A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |
Notes: Source: American Osteopathic Board of Neurology and Psychiatry, 2007 [1/1/2008: definition added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1689817447 | First Step, Inc | Psychiatry & Neurology | 3525 Resource Dr, Randallstown, MD 21133-4733 | 2009-04-09 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740631951 | Carrie Schmitt | Psychiatry & Neurology | 8470 Dorsey Run Rd, Jessup, MD 20794-9486 | 2016-06-29 |
1871999276 | Bergand Group | Psychiatry & Neurology | 1803 Harford Rd, Fallston, MD 21047 | 2014-11-12 |
1578876264 | Belitehorizonmedicalcenter | Psychiatry & Neurology | 26825 Pointlook Out Road, Stee, Leonardtown, MD 20650 | 2010-07-22 |
1003018813 | Donald Harry Taylor | Psychiatry & Neurology | 4545 Crain Hwy, Substance Abuse Services, White Plains, MD 20695-1050 | 2007-06-04 |
1649317264 | Marc Judah Fishman | Psychiatry & Neurology | 3800 Frederick Avenue, Na, Baltimore, MD 21229-3618 | 2007-01-31 |
1831284769 | Syed Asif H Ali | Psychiatry & Neurology | 13102 Autumn Dr, Silver Spring, MD 20904-3307 | 2006-10-04 |
1861599490 | Rhonda Lynn Allen | Psychiatry & Neurology | 5401 Loch Raven Blvd Fl 2, Baltimore, MD 21239-2902 | 2006-09-17 |
1952404840 | Samathanam N Abraham | Psychiatry & Neurology | 13207 Valley Dr, Rockville, MD 20850-3626 | 2006-09-06 |
1174634869 | Indu Mago Sud | Psychiatry & Neurology | 17958 Pond Rd, Ashton, MD 20861-9756 | 2006-08-31 |
1619082005 | Maryland Treatment Centers, Inc. | Psychiatry & Neurology | 14703 Avery Rd, Rockville, MD 20853-3605 | 2006-08-19 |
Find all providers with the same taxonomy |
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.