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GRASSROOTS HEALING
NPI 1902587124
Nurse Practitioner - Family in College Park, MD

Active since July 31, 2023
10105 BALTIMORE AVE APT 3401, COLLEGE PARK, MD 20740(410) 937-1766 Get Directions Write a Review

NPPES record last updated: July 31, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Grassroots Healing NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

GRASSROOTS HEALING (NPI 1902587124) is a healthcare organization registered as a family in College Park, Maryland and active in the NPI registry since July 2023. The organization lists Melissa Jackson, Owner, as its authorized official.

NPPES Registry Identity

NPI1902587124
Entity TypeOrganization
Primary Taxonomy363LF0000X
Legal Business NameGRASSROOTS HEALING
Location Address10105 BALTIMORE AVE APT 3401College Park, MD 20740-4231
Mailing Address10105 Baltimore Ave Apt 3401College Park, MD 20740-4231 · (410) 937-1766
Phone(410) 937-1766
Organization SubpartNo
Authorized OfficialMelissa JacksonOwner · (301) 276-4334
Enumeration DateJuly 31, 2023
NPPES CertifiedJuly 30, 2023
✔ NPI 1902587124 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
10105 BALTIMORE AVE APT 3401, College Park, MD 20740
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANANDA HOLISTICS AND WELLNESS CLINIC LLC
Nurse Practitioner (Family)
10105 BALTIMORE AVE APT 3401
COLLEGE PARK, MD 20740
Prince George's County (240) 622-5158

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Grassroots Healing's NPI number?

The NPI number for Grassroots Healing is 1902587124. It was assigned to this organization in the NPPES registry on July 31, 2023.

Where is Grassroots Healing located?

Grassroots Healing is located at 10105 Baltimore Ave Apt 3401, College Park, MD 20740. The listed phone number is (410) 937-1766.

What is Grassroots Healing's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

When was this NPI record last updated?

The NPPES record for Grassroots Healing was last updated on July 31, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.