SHEPPARD PRATT HEALTH SYSTEM, INC.


Address: 2001 Shadyside Ave, Suitland, MD 20746-4805
Phone: 3017022130

SHEPPARD PRATT HEALTH SYSTEM, INC. (NPI# 1922152578) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1922152578
Entity Type Organization
Organization Name SHEPPARD PRATT HEALTH SYSTEM, INC.
Other Organization Name FORBUSH SCHOOL AT EDGAR ALLEN POE
Practice Address 2001 Shadyside Ave
Suitland
MD 20746-4805
Mailing Address 6501 N Charles St
Baltimore
MD 21204-6819
Practice Telephone 3017022130
Practice Fax Number 3017024461
Mailing Telephone 4109383000
Mailing Fax Number 4109383159
Enumeration Date 2007-01-22
Last Update Date 2009-01-16
Authorized Official Name MS. BONNIE B. KATZ (VP CORPORATE BUSINESS DEVELOPMENT)
Authorized Official Telephone 4109383150
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QM0855X Clinic/Center
Specialization: Adolescent and Children Mental Health
3960 MD Ambulatory Health Care Facilities

Other Provider Identifier

State Issuer Identifier Type Code
MD 411238500 05
MD SCHOOL LICENSE NUMBER 3960 01

Other Provider/Organization Names

Other Name Type Code
Forbush School at Edgar Allen Poe Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1629247051 Sheppard Pratt Health System, Inc. Clinic/Center 610 E Diamond Ave Ste E, Gaithersburg, MD 20877-5332 2008-02-29
1225216948 Sheppard Pratt Health System, Inc. Clinic/Center 11201 Pepper Rd, Hunt Valley, MD 21031-1201 2008-02-05
1811041163 Sheppard Pratt Health System, Inc. Clinic/Center 407 Central Ave, Reisterstown, MD 21136-1854 2007-01-23
1104970565 Sheppard Pratt Health System, Inc. Clinic/Center 17000 National Hwy Nw, Frostburg, MD 21532-3206 2007-01-23
1518011659 Sheppard Pratt Health System, Inc. Clinic/Center 2940 Point of Rocks Road, Jefferson, MD 21755-0009 2007-01-23
1861546566 Sheppard Pratt Health System, Inc. Clinic/Center 17051 Oakmont Ave, Gaithersburg, MD 20877-4142 2007-01-22
1093869679 Sheppard Pratt Health System, Inc. Clinic/Center 4915 Aspen Hill Rd, Rockville, MD 20853-3709 2007-01-22
1932253598 Sheppard Pratt Health System, Inc. Clinic/Center 1135 Business Pkwy S, Westminster, MD 21157-3019 2007-01-22
1851324164 Sheppard Pratt Health System, Inc. Psychiatric Hospital 4100 College Ave, Ellicott City, MD 21041-0836 2006-07-09
1437556008 Sheppard Pratt Health System, Inc. Psychiatric Hospital 6501 N Charles St, Baltimore, MD 21204-6819 2014-11-26

Office Location

Street Address 2001 SHADYSIDE AVE
City SUITLAND
State MD
Zip Code 20746-4805

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Taxonomy Information

Taxonomy Code 261QM0855X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Adolescent and Children Mental Health

Taxonomy Definition

An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in children and adolescents. Services may be provided to parents and family members of the patient in the form of conjoint, group, or individual therapy, and education and/or training.
Notes: [7/1/2003: new]

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1720627581 Johns Hopkins Bayview Medical Center, Inc. Clinic/Center 5500 East Lombard Street, Room 1025, Baltimore, MD 21224 2019-12-27
1841847241 Imperial Healthcare Services LLC Clinic/Center 547 Riverside Dr Ste A, Salisbury, MD 21801-5369 2019-08-20
1437714862 Bolton Therapy & Wellness Clinic/Center 1534 Bolton St Ste 1, Baltimore, MD 21217-4203 2019-05-01
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Competitor

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City SUITLAND
Zip Code 20746

Improve Information

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Dataset Information

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.

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