RIDGE 103 LLC (NPI# 1851509103) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851509103 |
| Entity Type | Organization |
| Organization Name | RIDGE 103 LLC |
| Other Organization Name | RIDGE 103 OMHC |
| Practice Address |
1235 E Monument St Baltimore MD 21202-5327 |
| Mailing Address |
1235 East Monument Street Baltimore MD 21202 |
| Practice Telephone | 4103730070 |
| Practice Fax Number | 4103270542 |
| Mailing Telephone | 4103730070 |
| Mailing Fax Number | 4103270542 |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. ORLANDO ROSS DAVIS (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 4103730070 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
MD | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Ridge 103 OMHC | Other Name - Individual/Organization |
| Street Address |
1235 E MONUMENT ST |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21202-5327 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205861093 | Christine Baker | Family Medicine | 1235 E Monument St, Baltimore, MD 21202-5327 | 2006-07-11 |
| 1134615024 | Brynn M Huffman | Nurse Practitioner | 1235 E Monument St, Baltimore, MD 21202 | 2018-07-03 |
| 1841784907 | Erin Mahoney Laroque | Nurse Practitioner | 1235 E Monument St, Baltimore, MD 21202 | 2018-06-21 |
| 1205367745 | Christina Dias | Physician Assistant | 1235 E Monument St, Baltimore, MD 21202-5327 | 2017-03-26 |
| 1679022370 | Shusma Karki | Nurse Practitioner | 1235 E Monument St, Baltimore, MD 21202-5327 | 2016-09-23 |
| 1407201833 | Ann Rochell Ermitanio | Physician Assistant | 1235 E Monument St, Baltimore, MD 21202-5327 | 2016-05-04 |
| 1225429681 | Ashley Hibshman | Nurse Practitioner | 1235 E Monument St, Baltimore, MD 21202-5327 | 2015-02-06 |
| 1508268590 | Emma Kellaway Feinberg | Nurse Practitioner | 1235 E Monument St, Baltimore, MD 21202-5327 | 2014-09-22 |
| 1962819458 | Ali Minhal Thaver | Internal Medicine | 1235 E Monument St, Baltimore, MD 21202-5327 | 2014-07-16 |
| 1376868174 | Reginald O Crosley Md Pa | Clinic/Center | 1235 E Monument St, Baltimore, MD 21202-5327 | 2010-04-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750938650 | Anthony Graves | Behavior Technician | 414 Light Street, Baltimore, MD 21202 | 2019-08-25 |
| 1235786609 | Perfected Medical Billing & Consulting Service Inc. | Rehabilitation Counselor | 11 E Mt Royal Avenue, 3rd Flr Ste 2, Baltimore, MD 21202 | 2019-08-21 |
| 1700430246 | Ronie George | Nurse Practitioner | 345 St. Paul Place Dept of Pediatrics, Baltimore, MD 21202 | 2019-08-01 |
| 1750940185 | Katherine Wachter Mullins | Social Worker | 200 East North Ave, Related Services - Rm 210, Baltimore, MD 21202 | 2019-06-10 |
| 1720647175 | Ivelysse Claudio Cortes | Speech-Language Pathologist | Rsu/ofic of Spec Educ- Speech-language Department, 200 E North Avenue, Room 211, Baltimore, MD 21202 | 2019-06-10 |
| 1497314157 | Debera Marie Reznitsky | Speech-Language Pathologist | 200 East North Avenue, Related Services Rm 210, Baltimore, MD 21202 | 2019-06-06 |
| 1154989952 | Zirka Oksanna Hanas | Speech-Language Pathologist | 200 E. North Avenue, Related Services Room #210, Baltimore, MD 21202 | 2019-06-05 |
| 1750946224 | Lareneque Bartholomew | Counselor | 110 East Lexington Street, Suite 200, Baltimore, MD 21202 | 2019-05-09 |
| 1700349602 | Strategies, Inc. Behavior Analysis & Therapeutic Services | Behavioral Analyst | 414 Light Street, Baltimore, Md, Usa, 2103, Baltimore, MD 21202 | 2019-04-09 |
| 1902384068 | Medical Practice Billing and Solution, LLC | Clinic/Center | 224 N Gay Street, Baltimore, MD 21202 | 2018-08-01 |
| Find all providers in zip 21202 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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| 1649805078 | Empowering Minds Resource Center | Clinic/Center | 1800 N Charles St Fl 6, Baltimore, MD 21201-5920 | 2020-03-05 |
| Find all providers in BALTIMORE | ||||
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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.