| Vesta, Inc. | |
|
1202 Annapolis Rd Suite F Odenton MD 21113-1387 | |
| (240) 296-1370 | |
| (410) 672-2869 |
| Full Name | Vesta, Inc. |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 1202 Annapolis Rd, Odenton, Maryland |
| Authorized Official Name and Position | Jignesh Dalal (CEO) |
| Authorized Official Contact | 2402966099 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vesta, Inc. 9301 Annapolis Rd Ste 300 Lanham MD 20706-3125 Ph: (240) 296-6300 | Vesta, Inc. 1202 Annapolis Rd Suite F Odenton MD 21113-1387 Ph: (240) 296-1370 |
| NPI Number | 1790995017 |
|---|---|
| Provider Enumeration Date | 05/23/2007 |
| Last Update Date | 10/30/2024 |
| Medicare PECOS PAC ID | 3678568375 |
|---|---|
| Medicare Enrollment ID | O20050411001119 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790995017 | NPI | - | NPPES |
| 949L | Other | MD | MEDICARE |
| 260991602 | Medicaid | MD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 4567 (Maryland) | Secondary |
| 251S00000X | Community/behavioral Health | 4627 (Maryland) | Primary |
| Provider Name | Uma Murthy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578515706 PECOS PAC ID: 2062537731 Enrollment ID: I20100917000872 |
| Provider Name | Alimatu Nabie |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053820621 PECOS PAC ID: 8325305329 Enrollment ID: I20171129002722 |
| Provider Name | Uchechukwu Ifeji |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043736846 PECOS PAC ID: 6103189857 Enrollment ID: I20180411002750 |
| Provider Name | Emily R Bucheimer |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639623432 PECOS PAC ID: 1759629819 Enrollment ID: I20190214002546 |
| Provider Name | Kim Levone |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1487185674 PECOS PAC ID: 3072890961 Enrollment ID: I20200421002029 |
| Provider Name | Jessica Minor |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902487101 PECOS PAC ID: 6507263415 Enrollment ID: I20210920002970 |
| Provider Name | Sandor Orban |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1215317532 PECOS PAC ID: 2365812013 Enrollment ID: I20230208002394 |
| Provider Name | Deborah Ann Swanstrom |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124663794 PECOS PAC ID: 2062884521 Enrollment ID: I20230327001463 |
| Provider Name | Daniel E Pfannenstein |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1376159194 PECOS PAC ID: 1355796434 Enrollment ID: I20231010000958 |
| Provider Name | Adrienne Boettinger |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770127276 PECOS PAC ID: 2567813140 Enrollment ID: I20240108005688 |
| Provider Name | Sharon Mcnair-washington |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1952730012 PECOS PAC ID: 6406207695 Enrollment ID: I20240112000161 |
| Provider Name | Ian Wood |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1699330175 PECOS PAC ID: 6901258326 Enrollment ID: I20240125000472 |
| Provider Name | Lisa M Tarpley |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1740702455 PECOS PAC ID: 6800248402 Enrollment ID: I20240205000655 |
| Provider Name | Carol Agnes Cooper |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1356814131 PECOS PAC ID: 2062863251 Enrollment ID: I20240207000010 |
| Provider Name | Mary Eleanor Miner |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1528531613 PECOS PAC ID: 0446696249 Enrollment ID: I20240315001933 |
| Provider Name | Steven Gorozdos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1871991455 PECOS PAC ID: 6800111402 Enrollment ID: I20240410000532 |
| Provider Name | Jason Jeffery |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1770794422 PECOS PAC ID: 8628428562 Enrollment ID: I20241210001308 |
| Provider Name | Marissa Goon |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1649898206 PECOS PAC ID: 1052847936 Enrollment ID: I20241220003167 |
| Provider Name | Moriliat Olayinka Ajose |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003640301 PECOS PAC ID: 5799214102 Enrollment ID: I20250130001791 |
| Provider Name | Indigo Weinstein |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1174270250 PECOS PAC ID: 8426578063 Enrollment ID: I20250303003238 |
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