GENESIS PEDIATRICS OF MARYLAND ,INC. (NPI# 1427611284) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427611284 |
| Entity Type | Organization |
| Organization Name | GENESIS PEDIATRICS OF MARYLAND ,INC. |
| Other Organization Name | NONE |
| Practice Address |
4640 Forbes Blvd Ste 310 Lanham MD 20706-4889 |
| Practice Telephone | 2407648892 |
| Practice Fax Number | 2407648897 |
| Mailing Telephone | 2407648892 |
| Mailing Fax Number | 2407648897 |
| Enumeration Date | 2019-04-17 |
| Last Update Date | 2020-01-29 |
| Authorized Official Name | MRS. RACHAEL ADERONKE OWOOJE (CEO) |
| Authorized Official Telephone | 2407648892 |
| Authorized Official Credential | NURSE |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| Y | 3140N1450X |
Skilled Nursing Facility Specialization: Nursing Care, Pediatric |
Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 411385300 | 05 |
| Other Name | Type Code |
|---|---|
| none | Doing Business As Name - Organization |
| Street Address |
4640 FORBES BLVD STE 310 |
| City | LANHAM |
| State | MD |
| Zip Code | 20706-4889 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265954226 | Community Therapeutic Center,inc | Community/Behavioral Health | 4640 Forbes Blvd Ste 310, Lanham, MD 20706-4889 | 2017-07-12 |
| 1922641307 | Community Therapeutic Center,inc | Counselor | 4640 Forbes Blvd Ste 310, Lanham, MD 20706-4889 | 2019-10-18 |
| 1417416694 | Community Therapeutic Center,inc | Clinic/Center | 4640 Forbes Blvd Ste 310, Lanham, MD 20706-4889 | 2019-03-18 |
| 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 | 3140N1450X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| Specialization | Nursing Care, Pediatric |
| A nursing care facility designed and staffed for the provision of nursing care and appropriate educational and habilitative/rehabilitative services to children with multiple, complex or profound disabilities that can not be cared for in a less restrictive environment. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467088161 | First Option LLC | Skilled Nursing Facility | 5900 Princess Garden Pkwy, Lanham, MD 20706-2925 | 2020-03-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417596099 | Labil/ Labyem LLC. | Skilled Nursing Facility | 9233 Misting Ct, Waldorf, MD 20603-5724 | 2019-12-31 |
| 1750829495 | S.olani Yarl | Skilled Nursing Facility | 3622 Dean Dr, Suite N6, Hyattsville, MD 20782-1236 | 2017-02-02 |
| 1306295316 | Love One Home Healthcare,inc. | Skilled Nursing Facility | 1401 Mercantile Lane Suite 200j, Largo, MD 20774 | 2016-06-09 |
| 1538598735 | Mercy Care Providers, LLC | Skilled Nursing Facility | 4804 Continental Dr, Olney, MD 20832-2943 | 2013-11-07 |
| 1851615017 | Jps Health Services | Skilled Nursing Facility | 8116a Harford Rd, Baltimore, MD 21234 | 2010-03-17 |
| 1386979235 | Progressive Residential Nursing Care Services Inc | Skilled Nursing Facility | 1111 Kings Tree Dr, Bowie, MD 20721-1920 | 2009-10-10 |
| 1669601746 | Healing Vessels Inc | Skilled Nursing Facility | 911 Westlake Dr, Bowie, MD 20721-1850 | 2009-07-09 |
| 1881873057 | Devine Nursing Services Unlimited, Inc. | Skilled Nursing Facility | 4121 Sihler Oaks Trl, Owings Mills, MD 21117-5004 | 2007-10-24 |
| 1902819923 | Apnt, Inc. | Skilled Nursing Facility | 11584 Scaggsville Rd, Fulton, MD 20759-2206 | 2006-08-14 |
| 1790795672 | Hermitage Healthcare of Manokin Manor, LLC | Skilled Nursing Facility | 11974 Edgehill Terrace Rd, Princess Anne, MD 21853-2105 | 2006-08-09 |
| Find all providers with the same taxonomy | ||||
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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.