MD MATT LLC (NPI# 1669941175) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1669941175 |
| Entity Type | Organization |
| Organization Name | MD MATT LLC |
| Practice Address |
110 Painters Mill Rd Owings Mills MD 21117-4920 |
| Mailing Address |
110 Painters Mill Rd Ste 203 Owings Mills MD 21117-5543 |
| Practice Telephone | 4435594137 |
| Mailing Telephone | 4435594137 |
| Enumeration Date | 2018-11-14 |
| Last Update Date | 2019-10-03 |
| Authorized Official Name | WILLIAM CORY SHAFFER (CARE COORDINATOR) |
| Authorized Official Telephone | 4435594137 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1041C0700X |
Social Worker Specialization: Clinical |
Behavioral Health & Social Service Providers | ||
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 9216 Liberty Rd, Randallstown, MD 211333544 | 4435594137 | |
| 9533 Belair Rd Ste 201, Nottingham, MD 212361563 | 5105751785 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962011288 | Md Matt LLC | Nurse Practitioner | 10220 S Dolfield Rd Ste 106, Owings Mills, MD 21117-3660 | 2020-07-23 |
| 1578182614 | Md Matt LLC | Nurse Practitioner | 208 Transmission Ct, Linthicum Heights, MD 21090-2708 | 2020-04-09 |
| 1508493180 | Md Matt LLC | Nurse Practitioner | 12 Crain Hwy N, Glen Burnie, MD 21061-3565 | 2020-03-24 |
| 1619583200 | Md Matt LLC | Nurse Practitioner | 309 E Patrick St, Frederick, MD 21701-6792 | 2020-09-18 |
| 1861033441 | Md Matt LLC | Nurse Practitioner | 9533 Belair Rd, Nottingham, MD 21236-1563 | 2019-10-04 |
| Street Address |
110 PAINTERS MILL RD |
| City | OWINGS MILLS |
| State | MD |
| Zip Code | 21117-4920 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811998966 | Barry Ronald Berman | Oral & Maxillofacial Surgery | 110 Painters Mill Rd, Suite 8, Owings Mills, MD 21117-4920 | 2005-08-10 |
| 1265731202 | Barry R. Berman, D.d.s., P.a. | Dentist | 110 Painters Mill Rd, Suite 8, Owings Mills, MD 21117-4920 | 2011-03-16 |
| 1245279538 | Robert K Kraft | Psychologist | 110 Painters Mill Rd, Ste 23, Owings Mills, MD 21117-4920 | 2006-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699303727 | Modern Medicine Express Care | Clinic/Center | 1041 Campbell Meadow Rd, Owings Mills, MD 21117 | 2020-04-01 |
| 1679111892 | Abria Therapy, LLC | Behavioral Analyst | 10451 Mill Run Circle, Suite 400, Owings Mills, MD 21117 | 2019-12-18 |
| 1194384917 | Michele Dawson Overtoom | Pharmacist | Wegmans Pharmacy #125, 10100 Reisterstown Road, Owings Mills, MD 21117 | 2019-06-06 |
| 1033675897 | Grace Residential Services, LLC | Clinic/Center | 4117 Brookside Oaks Road, Owings Mills, MD 21117 | 2019-02-18 |
| 1801373246 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 10270 Mill Run Circle, Owings Mills, MD 21117 | 2018-07-27 |
| 1922513167 | Vamsh Health Services, LLC | Pharmacy | 10309 Grand Central Ave Ste 110, Owings Mills, MD 21117 | 2017-12-11 |
| 1215456652 | Safari Healthcare | Home Health | 4129 Brookside Oak Road, Owings Mills, MD 21117 | 2017-09-18 |
| 1639697964 | Rachel Tova Goldberg | Behavioral Analyst | 11907 Hunting Tweed Dr., Owings Mills, MD 21117 | 2017-09-07 |
| 1528599149 | Nest Home Care, LLC | In Home Supportive Care | 90 Painters Mill Rd Ste 223, Owings Mills, MD 21117 | 2017-03-24 |
| 1508221243 | Quality Home Care, LLC | In Home Supportive Care | 124 Embleton Road, Owings Mills, MD 21117 | 2015-12-23 |
| Find all providers in zip 21117 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144555293 | Joyce Miller Miskovic | Nurse Practitioner | 11200 Gundry Ln, Owings Mills, MD 21117-6254 | 2009-10-07 |
| 1043220593 | Judith W. Ryan | Nurse Practitioner | 10989 Red Run Blvd, Suite 208, Owings Mills, MD 21117-3283 | 2006-08-08 |
| 1538151345 | Marilyn Bochenko Andrews | Nurse Practitioner | 10085 Red Run Blvd, Suite 306, Gbmc At Owings Mills, Owings Mills, MD 21117 | 2005-08-17 |
| 1538506662 | Linnea Kristin Cheseldine | Nurse Practitioner | 25 Crossroads Dr, Suite 205, Owings Mills, MD 21117-5421 | 2013-05-30 |
| 1396035069 | Rosemary W Dodd | Nurse Practitioner | 25 Crossroads Dr, Suite 205, Owings Mills, MD 21117-5421 | 2011-04-14 |
| 1598085995 | Julia K Smith | Nurse Practitioner | 25 Crossroads Dr, Suite 312, Owings Mills, MD 21117-5421 | 2010-06-08 |
| 1457535437 | Augustina Olajumoke Opeewe-ojo | Nurse Practitioner | 6 Park Center Ct Ste 210, Owings Mills, MD 21117-5604 | 2007-12-26 |
| 1306962139 | Saba & Associates, M.d., P.a. | Nurse Practitioner | 5 Park Center Ct, Suite 200, Owings Mills, MD 21117-4201 | 2007-03-22 |
| 1083685689 | Tatiana G Smirnova | Nurse Practitioner | 25 Crossroads Dr, Suite 205, Owings Mills, MD 21117-5421 | 2006-01-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346841236 | Golden Oasis Healthcare Services LLC | Nurse Practitioner | 333 Old Line Ave, Laurel, MD 20724-2407 | 2020-11-05 |
| 1225636558 | Agnprx LLC | Nurse Practitioner | 5543 Bonnie Brook Rd, Cambridge, MD 21613-3437 | 2020-10-09 |
| 1417563891 | Barbara Katarzyna Wawryszyn | Nurse Practitioner | 12 Brook Farm Ct Unit E, Perry Hall, MD 21128-9042 | 2020-09-21 |
| 1659981728 | Jamie Briddell | Nurse Practitioner | 250 N Calvert St, Baltimore, MD 21202-3505 | 2020-08-04 |
| 1881202570 | Jisha S Varghese | Nurse Practitioner | 3257 Ramblewood Rd, Ellicott City, MD 21042-2445 | 2020-07-19 |
| 1710505524 | Jillian E Haney | Nurse Practitioner | 208 Plumtree Rd Ste C, Bel Air, MD 21015-6058 | 2020-07-08 |
| 1164040200 | Srkite Associates | Nurse Practitioner | 8 Sudbrook Ln Ste 1a, Pikesville, MD 21208-4132 | 2020-07-06 |
| 1447877279 | Katherine O'bryan | Nurse Practitioner | 176 Thomas Johnson Dr Ste 103, Frederick, MD 21702-4529 | 2020-06-27 |
| 1790300903 | Hall Diabetes Management and Resource Center PC | Nurse Practitioner | 1900 E Northern Pkwy Ste T1, Baltimore, MD 21239-2120 | 2020-06-12 |
| 1376162362 | Thomas Nemer II | Nurse Practitioner | 2225 Old Emmorton Rd Ste 111, Bel Air, MD 21015-6122 | 2020-04-10 |
| Find all providers with the same taxonomy | ||||
| City | OWINGS MILLS |
| Zip Code | 21117 |
Please comment or provide details below to improve the information on MD MATT LLC.
| 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.