Healthcare Provider Details

I. General information

NPI: 1164346805
Provider Name (Legal Business Name): LUMINIS HEALTH COMMUNITY CLINICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2026
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1750 FOREST DR
ANNAPOLIS MD
21401-4211
US

IV. Provider business mailing address

2000 MEDICAL PKWY STE 409
ANNAPOLIS MD
21401-3746
US

V. Phone/Fax

Practice location:
  • Phone: 443-481-1000
  • Fax:
Mailing address:
  • Phone: 443-481-5101
  • Fax: 443-481-4151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: MELISSA RAPATTONI
Title or Position: AO
Credential:
Phone: 443-481-5136