Jessco LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

PENDING Issued in MD

Legal business name

JESSCO LLC

Practice address

10308 Old Ocean City Blvd
Berlin, MD 21811-1132

Phone

(410) 641-9886

Fax

(410) 641-1746

NPI assigned

Oct 18, 2006

Last updated

Oct 28, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Judith Lee Galuardi

Title

Administrator

Phone

(410) 641-9886

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Listed as

Jessco LLCCCN 21C0001448

Medicare certification status

ActiveFrom the Provider of Services file

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Christopher James Galuardi, MD

  • Interventional Pain Medicine Physician
  • Berlin, MD
  • NPI 1396755286
  NPD (past)
• Wadid Youssef Zaky Salama, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Berlin, MD
  • NPI 1922205079
  NPD (past)
• Tabitha Kelly, PA

  • Physician Assistant
  • Milton, DE
  • NPI 1134630528
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225152000000",
    "number": "1033290499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 884",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218110884",
            "telephone_number": "410-641-9886",
            "fax_number": "410-641-1746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10308 OLD OCEAN CITY BLVD",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218111132",
            "telephone_number": "410-641-9886",
            "fax_number": "410-641-1746"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESSCO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2008-10-28",
        "status": "A",
        "authorized_official_last_name": "GALUARDI",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "410-641-9886",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MD",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "223Z",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexis James
• Darlene Anne Jameson, R.D., L.D.
• Jesse James Jarman, LCSW-C
• Ashley Brittney Jenkins
• Jerrold S. Canakis, MD PA
• Ron Allen Jewett
• Craig Johnson, PA-C
• Irene Johnson, LMSW
• Jalesa Amanda Johnson
• Julia Michelle Johnson

• Ambulatory Surgical Clinic/Center in Berlin, MD
• Providers in Berlin, MD by specialty
• Ambulatory Surgical Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.