NPIMap

Organization Active NPI

Univ of Maryland Otorhinolaryngology Head & Neck Surgery PA

  • Specialist
  • Baltimore, MD
National Provider Identifier
1033926423
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
UNIV OF MARYLAND OTORHINOLARYNGOLOGY HEAD & NECK SURGERY PA
Practice address
2200 Kernan Dr
Baltimore, MD 21207-6665
Phone
(410) 328-6897
Fax
(410) 328-2109
NPI assigned
Dec 18, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Authorized official

Name
Shavonda L Williams
Title
Corporate Director
Phone
(667) 214-2507

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

2200 Kernan Dr
Baltimore, MD 21207-6665

Mailing address

PO Box 64693
Baltimore, MD 21264-4693

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050729000661 MD Part B Supplier - Clinic/Group Practice 8820026974 Receives reassigned benefits from 34 practitioners
14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Towson, MD; Lutherville, MD; Columbia, MD; College Park, MD; Bel Air, MD; Baltimore, MD

Other NPIs on the same Medicare enrollment 14

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 14

National Provider Directory

National Provider Directory
Tax ID family
Univ of Maryland Otorhinolaryngology Head Neck Surgery PA17 organizations share this tax ID, including this one

Other organizations with this tax ID 16

Organizations that report the same tax identification number in the National Provider Directory.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1734480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734480000000",
    "number": "1033926423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64693",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 KERNAN DR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212076665",
            "telephone_number": "410-328-6897",
            "fax_number": "410-328-2109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIV OF MARYLAND OTORHINOLARYNGOLOGY HEAD & NECK SURGERY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-18",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "SHAVONDA",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CORPORATE DIRECTOR",
        "authorized_official_telephone_number": "667-214-2507"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.