PHYSICIAN GROUP WPCC (NPI# 1568508927) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568508927 |
| Entity Type | Organization |
| Organization Name | PHYSICIAN GROUP WPCC |
| Practice Address |
630 W Fayette St Baltimore MD 21201-1543 |
| Practice Telephone | 4102096201 |
| Practice Fax Number | 4102096209 |
| Mailing Telephone | 4102096201 |
| Mailing Fax Number | 4102096209 |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. ARCHIE T. WALLACE (CEO) |
| Authorized Official Telephone | 4102096201 |
| Authorized Official Credential | MBA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 273R00000X | Psychiatric Unit | MD | Hospital Units |
| Street Address |
630 W FAYETTE ST |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21201-1543 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760468623 | Comptroller of Maryland Central Payroll Bureau | Psychiatric Hospital | 630 W Fayette St, Baltimore, MD 21201 | 2005-12-21 |
| 1083944615 | Univeristy of Maryland Medical Center, Alcohol & Drug Abuse Prog Adap | Counselor | 630 W Fayette St, Baltimore, MD 21201-1543 | 2010-01-04 |
| 1538499165 | University of Maryland Med Systems Corp - Harambee | Counselor | 630 W Fayette St, Baltimore, MD 21201-1543 | 2010-01-04 |
| 1366687337 | Diane Ossip | Psychiatry & Neurology | 630 W Fayette St, Baltimore, MD 21201-1543 | 2008-12-04 |
| 1447407994 | Alicia Octavia Scott-darden | Registered Nurse | 630 W Fayette St, Third Floor, Baltimore, MD 21201-1543 | 2008-08-26 |
| 1689821233 | Tirzah Marie Strang | Social Worker | 630 W Fayette St, Third Floor, Baltimore, MD 21201-1543 | 2008-08-26 |
| 1851553911 | Natalie Hart | Registered Nurse | 630 W Fayette St, Third Floor, Baltimore, MD 21201-1543 | 2008-06-30 |
| 1669676177 | Yolanda Marie Jones | Social Worker | 630 W Fayette St, Fourth Floor, Baltimore, MD 21201-1543 | 2007-06-11 |
| 1386866606 | Mary Claire Kelly-schultze | Social Worker | 630 W Fayette St, Third Floor, Baltimore, MD 21201-1543 | 2007-05-03 |
| 1730300021 | Maryam Shafiah Suraleigh | Social Worker | 630 W Fayette St, Third Floor, Baltimore, MD 21201-1543 | 2007-05-02 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518585470 | Meshref Ayed Alshehri | Student in an Organized Health Care Education/Training Program | 22 S. Greene Street, Room N3e09, Baltimore, MD 21201 | 2020-07-08 |
| 1306462411 | Michael Julian Wong | Student in an Organized Health Care Education/Training Program | University of Maryland, Department of Anesthesiology, 22 S Green St, S11b, Baltimore, MD 21201 | 2020-06-24 |
| 1740817733 | Martha Kaitlyn Coghlan | Student in an Organized Health Care Education/Training Program | Ummc Ob/gyn, 22 S. Greene St., Baltimore, MD 21201 | 2020-03-27 |
| 1629606637 | Taylor Renee Kai | Student in an Organized Health Care Education/Training Program | University of Maryland, 22 S. Greene Street, Room N3e09, Baltimore, MD 21201 | 2020-03-27 |
| 1295362697 | Brittany A Oster | Student in an Organized Health Care Education/Training Program | 110 S. Paca Street 6th Floor, Suite 300, Baltimore, MD 21201 | 2020-03-25 |
| 1346877735 | Kayvon Michael Mobarakeh | Student in an Organized Health Care Education/Training Program | University of Maryland Department of Anesthesiology, 22 S Greene St, S11c, Baltimore, MD 21201 | 2020-03-25 |
| 1598392284 | Zachary Allan Hagen | Student in an Organized Health Care Education/Training Program | 110 S. Paca Street, 6th Flr., Suite 200, Baltimore, MD 21201 | 2020-03-24 |
| 1700430055 | Jaime Semchuk | Student in an Organized Health Care Education/Training Program | 737 West Lombard, Baltimore, MD 21201 | 2019-07-25 |
| 1952861619 | Zachary Daniel Sanford | Student in an Organized Health Care Education/Training Program | 22 S Greene Street S8b12, Baltimore, MD 21201 | 2019-03-20 |
| 1114487840 | Spencer Sykes Lovegrove | Student in an Organized Health Care Education/Training Program | 110 S. Paca Street, Sixth Floor, Suite 200, Baltimore, Sixth Floor, Suite 200, Baltimore, MD 21201 | 2019-03-20 |
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| Taxonomy Code | 273R00000X |
| Grouping | Hospital Units |
| Classification | Psychiatric Unit |
| In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning. |
| Notes: Source: (1) AHA Annual Survey p. A10 1996 AHA Guide; (2) Code of Federal Regulations #42, Section 412.27. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700436813 | Excellent Healthcare & Psychiatric Rehabilitation Program Services Inc | Psychiatric Unit | 4002 W Belvedere Ave Unit A, Baltimore, MD 21215-5502 | 2019-09-19 |
| 1306271929 | Sinai Hospital Addictions Recovery Program | Psychiatric Unit | 2440 Cylburn Avenue, Baltimore, MD 21215 | 2013-09-13 |
| 1861958662 | Unlimited Bounds Human Services LLC | Psychiatric Unit | 1 North Charles Street, 4th Floor, Baltimore, MD 21201 | 2019-02-16 |
| 1831649466 | Bon Secours Hospital Baltimore, Inc | Psychiatric Unit | 2000 W Baltimore St, Baltimore, MD 21223-1558 | 2016-10-06 |
| 1316497944 | Bon Secours Hospital Baltimore, Inc | Psychiatric Unit | 2000 W Baltimore St, Baltimore, MD 21223-1558 | 2016-10-06 |
| 1417407040 | Bon Secours Hospital Baltimore, Inc | Psychiatric Unit | 2000 W Baltimore St, Baltimore, MD 21223-1558 | 2016-10-06 |
| 1134373053 | Franklin Square Hospital Center, Inc. | Psychiatric Unit | 9105 Franklin Square Dr, Suite 102, 104, Baltimore, MD 21237-3930 | 2008-11-05 |
| 1487741427 | The Union Memorial Hospital | Psychiatric Unit | 201 E University Pkwy, Baltimore, MD 21218-2829 | 2006-10-10 |
| 1184712085 | Franklin Square Hospital Center, Inc | Psychiatric Unit | 9000 Franklin Square Dr, Baltimore, MD 21237 | 2006-10-10 |
| 1487759742 | Franklin Square Hospital Center, Inc. | Psychiatric Unit | 9000 Franklin Square Dr, Baltimore, MD 21237-3901 | 2006-09-13 |
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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.