LIFESTREAM HEALTH CENTER (NPI# 1841674777) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841674777 |
| Entity Type | Organization |
| Organization Name | LIFESTREAM HEALTH CENTER |
| Practice Address |
4000 Mitchellville Rd B322 Bowie MD 20716-3104 |
| Practice Telephone | 3018600305 |
| Practice Fax Number | 3018600307 |
| Mailing Telephone | 3018600305 |
| Mailing Fax Number | 3018600307 |
| Enumeration Date | 2015-07-09 |
| Last Update Date | 2020-06-11 |
| NPI Deactivation Date | 06/04/2020 |
| NPI Reactivation Date | 2020-06-11 |
| Authorized Official Name | DR. SARAH ANN MERRITT (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 3018600305 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073059515 | Lifestream Health Center | Clinical Medical Laboratory | 4000 Mitchellville Rd, Suite B322, Bowie, MD 20716-3104 | 2017-01-09 |
| 1881728996 | Lifestream Health Center | Specialist | 4000 Mitchellville Rd, Suite B322, Bowie, MD 20716 | 2007-03-14 |
| Street Address |
4000 MITCHELLVILLE RD B322 |
| City | BOWIE |
| State | MD |
| Zip Code | 20716-3104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962408955 | Lynne Ann Jacobs | Nurse Practitioner | 4000 Mitchellville Rd, A-414, Bowie, MD 20716-3104 | 2005-06-23 |
| 1073059515 | Lifestream Health Center | Clinical Medical Laboratory | 4000 Mitchellville Rd, Suite B322, Bowie, MD 20716-3104 | 2017-01-09 |
| 1730531278 | Jessica Lynn Rizzo | Physical Therapist | 4000 Mitchellville Rd, Suite A404, Bowie, MD 20716 | 2016-07-08 |
| 1538535992 | Lifestyle Hearing Professionals, LLC | Audiologist | 4000 Mitchellville Rd, Suite B124, Bowie, MD 20716-3104 | 2015-08-19 |
| 1720468663 | Capital Orthopaedic Specialists LLC | Physical Therapist | 4000 Mitchellville Rd, Suite B116, Bowie, MD 20716-3104 | 2015-06-05 |
| 1366820284 | Capital Orthopaedic Specialists LLC | Durable Medical Equipment & Medical Supplies | 4000 Mitchellville Rd, Suite B 116, Bowie, MD 20716-3104 | 2015-05-12 |
| 1497154223 | Made To Move LLC | Clinic/Center | 4000 Mitchellville Rd, Suite 404a, Bowie, MD 20716-3104 | 2014-08-18 |
| 1841606258 | Doctors of Audiology, LLC | Audiologist | 4000 Mitchellville Rd, Suite B124, Bowie, MD 20716-3104 | 2014-07-07 |
| 1881007995 | Digestive and Biliary Disease Consultants LLC | Hospitalist | 4000 Mitchellville Rd, Ste B 430, Bowie, MD 20716-3104 | 2014-06-05 |
| 1104166685 | Chesapeake Otolaryngology Associates | Audiologist | 4000 Mitchellville Rd, A414, Bowie, MD 20716-3104 | 2013-02-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508330903 | Stacey Katheryn Lundquist | Counselor | 3060 Michellville Rd, Suite 106, Bowie, MD 20716 | 2019-01-18 |
| 1427528819 | Nicole Rudd | Counselor | 4315 Northview Dr, Bowie, MD 20716 | 2018-11-28 |
| 1427541838 | Outreach Recovery II, LLC | Internal Medicine | 4201 Northview Dr Ste 104, Bowie, MD 20716 | 2018-06-11 |
| 1487143608 | Fatimata Koroma | Counselor | 3953 Elite St, Bowie, MD 20716 | 2018-05-02 |
| 1043739618 | Breanna Collinson | Behavior Technician | 3017 New Oak Ln., Bowie, MD 20716 | 2017-09-15 |
| 1790202000 | Sierra Williams Howell | Nurse Practitioner | 2802 Eliston Street, Bowie, MD 20716 | 2017-08-28 |
| 1487175105 | Martine Jean | Technician | 15911 Pointer Ridge Rd, Bowie, MD 20716 | 2017-07-03 |
| 1902254493 | Olachi Enwerem | Licensed Practical Nurse | 16206 Audubon Lane, Bowie, MD 20716 | 2016-05-25 |
| 1780039230 | Debra Lachaune Garris | Specialist | 3042 Mitchiville Road, Bowie, MD 20716 | 2016-05-03 |
| 1750782553 | Medical Trasportation Systems LLC | Non-emergency Medical Transport (VAN) | 16036 Elegant Ave, Bowie, MD 20716 | 2014-09-11 |
| Find all providers in zip 20716 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922469865 | Choice Pain & Rebabilitation Center LLC | Non-Pharmacy Dispensing Site | 5102 Cornelias Prospect Dr, Bowie, MD 20720-3375 | 2016-03-18 |
| 1427525070 | Center for Pain Management LLC | Non-Pharmacy Dispensing Site | 16900 Science Drive, Suite 100, Bowie, MD 20715 | 2018-10-31 |
| 1629528948 | Patient First Maryland Medical Group | Non-Pharmacy Dispensing Site | 15459 Annapolis Road, Bowie, MD 20715 | 2016-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144864489 | Welldoc, Inc. | Non-Pharmacy Dispensing Site | 10221 Wincopin Cir Ste 150, Columbia, MD 21044-3444 | 2019-10-30 |
| 1619444213 | Center for Pain Management LLC | Non-Pharmacy Dispensing Site | 940 Seton Dr Ste A, Cumberland, MD 21502-1871 | 2018-11-01 |
| 1518434117 | Center for Pain Management LLC | Non-Pharmacy Dispensing Site | 8455 Colesville Road, Suite 200, Silver Spring, MD 20910 | 2018-11-01 |
| 1003383720 | Center for Pain Management LLC | Non-Pharmacy Dispensing Site | 6820 Hospital Dr Ste 302, Baltimore, MD 21237-4362 | 2018-10-31 |
| 1003383654 | Center for Pain Management LLC | Non-Pharmacy Dispensing Site | 1838 Greene Tree Rd Ste 150, Pikesville, MD 21208-7100 | 2018-10-31 |
| 1629545272 | Center for Pain Management LLC | Non-Pharmacy Dispensing Site | 510 Upper Chesapeake Dr Ste 415, Bel Air, MD 21014-4336 | 2018-10-31 |
| 1144744707 | Patient First Maryland Medical Group Pllc | Non-Pharmacy Dispensing Site | 6201 Annapolis Road, Landover Hills, MD 20784 | 2017-07-26 |
| 1093178923 | Jeffrey Y H Chung LLC | Non-Pharmacy Dispensing Site | 14201 Laurel Park Dr Ste 104, Laurel, MD 20707-5203 | 2016-03-29 |
| 1871967414 | Annapolis Foot and Ankle Center | Non-Pharmacy Dispensing Site | 130 Love Point Rd Ste 103, Stevensville, MD 21666-2132 | 2015-11-19 |
| 1417330754 | Welgo | Non-Pharmacy Dispensing Site | 4572 Beech Rd, Temple Hills, MD 20748-6704 | 2015-07-06 |
| 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.