Luminis Health Primary Care Ginger Cove
Organization Active NPI Internal Medicine Physician · Annapolis, MD
NPI 1013786433 · NPPES record last updated Oct 17, 2024
Key facts
- NPI
- 1013786433
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- LUMINIS HEALTH PRIMARY CARE GINGER COVE
- Practice address
- 4000 River Crescent Dr
Annapolis, MD 21401-7721 - Phone
- (443) 481-1000
- NPI assigned
- Dec 27, 2023
- Organization subpart
- Yes
- Parent organization (as reported)
- LUMINIS HEALTH
Authorized official
- Name
- Kayla Snyder
- Title
- Enrollment Manager
- Phone
- (443) 481-5136
Corporate family (same tax ID) 14
Practitioners 3
-
Lindsey Nicole Nazarek, D.O.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050317000146 | MD | Part B Supplier - Clinic/Group Practice | 2860447315 |
Receives reassigned benefits from 897 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
- Tax ID family
- Anne Arundel Phys Group LLC
- Part of
- Anne Arundel Phys Group LLC
Interoperability endpoints
- https://epicarr.aahs.org/FHIR/api/FHIR/R4/
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | Yes |
Addresses
Primary practice location
4000 River Crescent Dr
Annapolis, MD 21401-7721
Mailing address
2000 Medical Pkwy Ste 409
Annapolis, MD 21401-3746
Phone (443) 481-5136
Other providers in Annapolis, MD
- Luminis Health Medical Group, LLC
- Luminis Health Pathways, Inc.
- Luminis Health Pathways, Inc.
- Luminis Health Pathways, Inc.
- Luminis Health Pathways, Inc.
- Luminous Psychotherapy, LLC
- Madeline Reid Lupinek
- Martha Foster Lurz
- Kristin E Lutz
- Luxottica of America Inc
All providers in Annapolis, MD · Internal Medicine Physician in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 17, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.