Type 1 Individual Provider
NPI 1952543191 · Exclusive Provider Organization · Silver Spring, MD
Type 1 Individual Provider is a Exclusive Provider Organization organization in Silver Spring, MD (NPI 1952543191).
Provider details
- NPI number
- 1952543191
- Entity type
- Organization
- Primary specialty
- Exclusive Provider OrganizationManaged Care Organizations
- Organization subpart
- No
- Authorized official
- Brena Gibson, Human Resources Director(301) 439-7191
- License
- LC2381 (MD)
Specialties & taxonomies
Managed Care Organizations
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Other name
- Type 1 Individual Provider
Registry dates
- Enumerated
- 2009-04-02
- Last updated
- 2009-04-08
Frequently asked questions
- What is Type 1 Individual Provider's NPI number?
- Type 1 Individual Provider's National Provider Identifier (NPI) is 1952543191, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Type 1 Individual Provider?
- Type 1 Individual Provider is classified in the NPPES registry as Exclusive Provider Organization (Managed Care Organizations).
- Where is Type 1 Individual Provider located?
- Type 1 Individual Provider's practice location on file with NPPES is 1620 Elton Rd, Silver Spring, MD 20903-1740.
- What is Type 1 Individual Provider's phone number?
- The practice phone number listed in the NPPES registry for Type 1 Individual Provider is (301) 439-7191.
- Who is the authorized official for Type 1 Individual Provider?
- The authorized official listed on Type 1 Individual Provider's NPPES record is Brena Gibson, Human Resources Director. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Type 1 Individual Provider's NPI active?
- Yes — Type 1 Individual Provider's NPI (1952543191) is active in the NPPES registry as of the last update on 2009-04-08.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.