PREVENTION &MANAGEMENT OUTREACH CLINIC INC. (NPI# 1619122504) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619122504 |
| Entity Type | Organization |
| Organization Name | PREVENTION &MANAGEMENT OUTREACH CLINIC INC. |
| Other Organization Name | PREVENTION & MANAGEMENT OUTREACH CLINIC INC. |
| Practice Address |
5941 Millrace Ct Unit D103 Columbia MD 21045-7204 |
| Practice Telephone | 4103123126 |
| Mailing Telephone | 4103123126 |
| Enumeration Date | 2008-11-19 |
| Last Update Date | 2008-11-19 |
| Authorized Official Name | MS. LISA BUSH (PRESIDENT/CEO) |
| Authorized Official Telephone | 4103123126 |
| Is Organization Subpart | Y |
| Parent Organization Name | 438-31-0969 |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 305R00000X | Preferred Provider Organization | MD | Managed Care Organizations | |
| N | 305R00000X | Preferred Provider Organization | 0000000000 | MD | Managed Care Organizations |
| N | 305R00000X | Preferred Provider Organization | 30500000X | MD | Managed Care Organizations |
| Y | 305R00000X | Preferred Provider Organization | Managed Care Organizations |
| Other Name | Type Code |
|---|---|
| Prevention & Management Outreach Clinic Inc. | Former Legal Business Name - Organization |
| Street Address |
5941 MILLRACE CT UNIT D103 |
| City | COLUMBIA |
| State | MD |
| Zip Code | 21045-7204 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497374136 | Keenan Eldridge | Behavior Technician | 8950 Md-108, Suite 100, Columbia, MD 21045 | 2020-04-13 |
| 1730724220 | Luci Lee Redman Cassella | Family Medicine | 8900 Columbia 100 Parway Suite G, Columbia, MD 21045 | 2019-11-08 |
| 1417519414 | Howard County Health Department | Clinic/Center | Cradlerock Elementary School-based Wellness Center, 6700 Cradlerock Way, Columbia, MD 21045 | 2019-07-01 |
| 1649754490 | Dana Pirzchalski | Behavioral Analyst | 8815 Columbia Parkwary, 4, Columbia, MD 21045 | 2018-09-18 |
| 1871089177 | Melissa Jo Kennedy | Behavior Technician | 8815 Columbia Parkway, 4, Columbia, MD 21045 | 2018-07-10 |
| 1497246193 | Kjd | Physical Therapist | 8900 Columbia 100 Pkwy Ste C, Columbia, MD 21045 | 2018-05-29 |
| 1174010276 | Roger Lee | Audiologist | 8600 Snowden River Pkwy #309, Columbia, MD 21045 | 2018-04-16 |
| 1811497910 | Dominique Nichole Hale | Behavior Technician | 8115 Columbia 100 Parkway, Suite 4, Columbia, MD 21045 | 2018-02-15 |
| 1982116802 | Bradley D. Stiles | Acupuncturist | 6257 Deep River Cyn, Columbia, MD 21045 | 2017-11-01 |
| 1194234849 | University of Maryland Eye Associates, P.a. | Eyewear Supplier (Equipment, not the service) | 5900 Waterloo Road, Suite 230, Columbia, MD 21045 | 2017-09-26 |
| Find all providers in zip 21045 | ||||
| Taxonomy Code | 305R00000X |
| Grouping | Managed Care Organizations |
| Classification | Preferred Provider Organization |
| A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/ October 1995, p. 62 |
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| 1619154499 | Atkinson Group Inc | Preferred Provider Organization | 1400 Farrington Way Apt C, Columbia, SC 29210-6075 | 2008-01-23 |
| 1023488657 | Blessing Many Souls | Preferred Provider Organization | 502 Washington St, Columbia, MS 39429-8711 | 2015-09-24 |
| 1710222476 | Columbia Implants and Periodontics L.L.C. | Preferred Provider Organization | 201 W Broadway Ste 5a, Columbia, MO 65203-3842 | 2012-12-06 |
| 1780968347 | Counseling and Innovative Treatment Services | Preferred Provider Organization | 2712 Middleburg Dr, Suite 206, Columbia, SC 29204-2415 | 2011-09-30 |
| 1386882017 | Abundant Home Care Solutions LLC | Preferred Provider Organization | 2611 Forest Dr, Suite 206, Columbia, SC 29204-2379 | 2009-02-03 |
| 1164644142 | Peter Dexheimer Pa | Preferred Provider Organization | 10840 Little Patuxent Pkwy, Suite 203, Columbia, MD 21044-3115 | 2007-05-02 |
| 1447383666 | Pediatric Associates, P.a. | Preferred Provider Organization | 14 Richland Medical Park Dr, Suite 410, Columbia, SC 29203-6877 | 2007-03-14 |
| 1487759940 | First Presbyterian Church Counseling Center, Inc. | Preferred Provider Organization | 1500 Lady St, Columbia, SC 29201-3402 | 2006-09-13 |
| Find all providers in COLUMBIA | ||||
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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.