BODYWORKS MEDICAL (NPI# 1265068373) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265068373 |
| Entity Type | Organization |
| Organization Name | BODYWORKS MEDICAL |
| Practice Address |
St. Agnes Medical Center 3455 Wilkens Ave Suite 100 Baltimore MD 21229 |
| Mailing Address |
13013 Davenport Dr Brandywine MD 20613-5683 |
| Practice Telephone | 2404478036 |
| Mailing Telephone | 2022707542 |
| Mailing Fax Number | 2402132335 |
| Enumeration Date | 2020-03-20 |
| Last Update Date | 2020-03-20 |
| Authorized Official Name | DR. PHILLIP SHERMAN RAGLAND (PRESIDENT) |
| Authorized Official Telephone | 2404483279 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 968419100 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861963167 | Bodyworks Medical | Nurse Practitioner | 12805 Old Fort Rd Ste 301, Fort Washington, MD 20744-2814 | 2018-12-11 |
| Street Address |
ST. AGNES MEDICAL CENTER 3455 WILKENS AVE SUITE 100 |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21229 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750932430 | Amanda Felix | Nurse Practitioner | 5411 Old Frederick Road, Catonsville, MD 21229 | 2019-09-24 |
| 1497317853 | Wakeelat A Adeoye | Nurse Practitioner | 5411 0ld Fredrick Rd, Suite 7, Baltimore, MD 21229 | 2019-07-05 |
| 1598328080 | Oprah Cherelle Keyes | Social Worker | 4511 Birchwood Drive, Baltimore, MD 21229 | 2019-04-19 |
| 1477051779 | Shahin Vohara | Dentist | Dental Dreams, 4510 Edmondson Avenue, Edmondson Village Shopping Center, Baltimore, MD 21229 | 2018-02-01 |
| 1386179299 | Sharon Mccollough | Counselor | 3219 Phelps Lane, First Floor, Baltimore, MD 21229 | 2017-04-28 |
| 1184175697 | Yekeen Odewale | Registered Nurse | 5411 Old Frederick Rd Ste 7, Baltimore, MD 21229 | 2016-10-19 |
| 1942608070 | Charity Ashe | Social Worker | 4024 Colborne Rd, Baltimore, MD 21229 | 2014-12-05 |
| 1376947127 | Sumanya Venkat Rao | Dentist | 4510 Edmondson Ave, Baltimore, MD 21229 | 2014-10-21 |
| 1497091573 | Anita Phillips | Social Worker | 5110 Frederick Avenue, Baltimore, MD 21229 | 2012-12-18 |
| 1104179704 | Shaunte Monet Hairston | Technician, Pathology | 1130 Cooks Ln, Baltimore, MD 21229 | 2012-10-19 |
| Find all providers in zip 21229 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629615901 | Regen Medical LLC | Clinic/Center | 3916 Hickory Ave, Baltimore, MD 21211-1834 | 2019-12-05 |
| 1932526191 | Doctors Plus Medical Center, Inc. | Clinic/Center | 7640 Belair Rd, Baltimore, MD 21236-4088 | 2014-03-26 |
| 1376871996 | Alan A. Rosen, M.d., P.a. | Clinic/Center | 2411 W. Belvedere Avenue, Suite 306, Baltimore, MD 21215 | 2009-11-19 |
| 1538286174 | State of Marlyand | Clinic/Center | 1000 Hilltop Cir, Baltimore, MD 21250-0001 | 2007-03-26 |
| 1063456549 | Medstar Physician Partners | Clinic/Center | 107 Beacon Rd, Baltimore, MD 21220-3504 | 2006-06-15 |
| 1679512909 | Shock Trauma Associates, P.a. | Clinic/Center | 11 S Paca St, Suite 500, Baltimore, MD 21201-1791 | 2006-06-05 |
| 1487262473 | Halyard Behavioral Health & Wellness | Clinic/Center | 2415 Maryland Ave, Baltimore, MD 21218-5017 | 2020-07-16 |
| 1043798259 | Johns Hopkins University | Clinic/Center | 600 N Wolfe St, Baltimore, MD 21287-0005 | 2018-07-31 |
| 1891140653 | The House of Nehemiah Outreach and Ministries | Clinic/Center | 3300 Windsor Ave, Baltimore, MD 21216-2616 | 2016-04-29 |
| 1215327259 | Kennedy Krieger Associates, Inc - Mental Health Group Provider | Clinic/Center | 707 N. Broadway, Baltimore, MD 21205 | 2015-01-29 |
| Find all providers in BALTIMORE | ||||
Please comment or provide details below to improve the information on BODYWORKS MEDICAL.
| 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.