IMMEDIATE CARE MEDICAL CENTER (NPI# 1609950146) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609950146 |
| Entity Type | Organization |
| Organization Name | IMMEDIATE CARE MEDICAL CENTER |
| Practice Address |
11722 Reisterstown Rd Reisterstown MD 21136-3302 |
| Practice Telephone | 4108335000 |
| Practice Fax Number | 4108331433 |
| Mailing Telephone | 4108335000 |
| Mailing Fax Number | 4108331433 |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2014-07-08 |
| Authorized Official Name | MRS. PATRICIA C NWAOGBO (OFFICE MANAGER) |
| Authorized Official Telephone | 4108335000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760566228 | Immediate Care Medical Center | Internal Medicine | 7010 Ritchie Hwy, Glen Burnie, MD 21061-2902 | 2006-10-24 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Massachusetts Corporations | IMMEDIATE CARE MEDICAL CENTER,INC. | 85 Englewood Road, Longmeadow, MA 01106 |
| Street Address |
11722 REISTERSTOWN RD |
| City | REISTERSTOWN |
| State | MD |
| Zip Code | 21136-3302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720248198 | Keith D Wilson Jr. | General Practice | 11722 Reisterstown Rd, Reisterstown, MD 21136-3302 | 2008-06-10 |
| 1558409953 | Paula R Lyons | Family Medicine | 11722 Reisterstown Rd, Reisterstown, MD 21136-3302 | 2007-02-01 |
| 1871657825 | Immediate Care Urgent Care-reisterstown, LLC | Clinic/Center | 11722 Reisterstown Rd, Reisterstown, MD 21136-3302 | 2006-12-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336791276 | Iyawamiwa Shittu | Counselor | 11 Chartley Drive, Reisterstown, MD 21136 | 2019-07-11 |
| 1508334517 | Amanda Britton | Speech-Language Pathologist | 12039 Reisterstown Rd., Reisterstown, MD 21136 | 2018-11-07 |
| 1366964272 | Marc Manko | Physician Assistant | 12608 Mt. Laurel Ct., Reisterstown, MD 21136 | 2017-07-12 |
| 1518325794 | Diana Jebaraj | Occupational Therapist | 15 Sunday Ct, Reisterstown, MD 21136 | 2016-02-03 |
| 1164816823 | Golda-amit Incorporated | Supports Brokerage | 11919 Tarragon Rd, Apt A, Reisterstown, MD 21136 | 2015-03-20 |
| 1073925210 | Irina Koyfman | Nurse Practitioner | 321 Chamborley Drive, Reisterstown, MD 21136 | 2014-05-22 |
| 1033462627 | Tracy Brenton | Counselor | 14450 Hanover Pike, Reisterstown, MD 21136 | 2012-10-19 |
| 1760738884 | Bonnie Lynne Haines | Massage Therapist | 141 Westminster Pike, Reisterstown, MD 21136 | 2012-07-26 |
| 1588921464 | Alexsandr Fishman | Dentist | 11710 Reisterstown Rd Ste 201, Reisterstown, MD 21136 | 2012-04-18 |
| 1992000954 | Darlene L. Reaka Israel | Nurse Practitioner | 23 Chartley Park Rd, Reisterstown, MD 21136 | 2011-01-21 |
| Find all providers in zip 21136 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063699569 | Victoria V Wilson | Family Medicine | 113 Westminster Pike, Suite 101, Reisterstown, MD 21136-1047 | 2008-01-28 |
| 1629624887 | Nyeinpu Woah-tee | Family Medicine | 100 Owings Ct, Reisterstown, MD 21136-6428 | 2019-08-14 |
| 1487061800 | Carroll Health Group, LLC | Family Medicine | 113 Westminster Pike, Suite 101, Reisterstown, MD 21136-1047 | 2014-07-17 |
| 1558409953 | Paula R Lyons | Family Medicine | 11722 Reisterstown Rd, Reisterstown, MD 21136-3302 | 2007-02-01 |
| 1235109281 | Harold Benton Bob | Family Medicine | 25 Main Street, Suite 200, Reisterstown, MD 21136 | 2006-01-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699375378 | Coastal Wellness Recovery | Family Medicine | 820 E Main St Unit 3, Salisbury, MD 21804-5025 | 2020-10-30 |
| 1770182693 | Britni Morgan | Family Medicine | 13620 Crayton Blvd Ste B, Hagerstown, MD 21742-2335 | 2020-10-21 |
| 1437757267 | Janice C Vaz | Family Medicine | 13912 Natia Manor Dr, North Potomac, MD 20878-4859 | 2020-10-14 |
| 1053918847 | Katherine Susan Dennis | Family Medicine | 1322 Belmont Ave Ste 201, Salisbury, MD 21804-4593 | 2020-10-05 |
| 1740893650 | Melissa Josanne Richards | Family Medicine | 4511 Old Court Rd, Pikesville, MD 21208-2428 | 2020-08-29 |
| 1861003121 | Mind Algn LLC | Family Medicine | 7920 Norfolk Ave Ste 290, Bethesda, MD 20814-2500 | 2020-08-11 |
| 1669095402 | Refresh Pain and Wellness, LLC | Family Medicine | 6314 Windsor Mill Rd Ste 100, Gwynn Oak, MD 21207-6078 | 2020-05-27 |
| 1386265015 | Judi De'landa Brown-brown | Family Medicine | 7522 Gilley Ter, Rosedale, MD 21237-3703 | 2020-05-05 |
| 1073142147 | Lakeside Med, LLC | Family Medicine | 7820b Wormans Mill Rd # 276, Frederick, MD 21701-3034 | 2020-04-02 |
| 1225662828 | Federal Hill Medical Center | Family Medicine | 724 A Light Street, Baltimore, MD 21230-3850 | 2020-02-24 |
| Find all providers with the same taxonomy | ||||
| City | REISTERSTOWN |
| Zip Code | 21136 |
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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.