NPIMap

Organization Active NPI

University of Maryland Community Medical Group, Inc.

  • Family Medicine Physician
  • Centreville, MD
National Provider Identifier
1033969142
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
UNIVERSITY OF MARYLAND COMMUNITY MEDICAL GROUP, INC.
Practice address
2540 Centreville Rd
Centreville, MD 21617-2681
Phone
(410) 758-4432
NPI assigned
Mar 25, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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

Authorized official

Name
Paul Stephen Nicholson
Title
Ao
Phone
(410) 337-1602

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

2540 Centreville Rd
Centreville, MD 21617-2681

Mailing address

900 Elkridge Landing Rd FL 2
Linthicum, MD 21090-2924

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D0864462University of Maryland Community Medical Group2540 Centreville Road, Centreville, MD 21617Provider-performed microscopyAug 31, 2026

National Provider Directory

National Provider Directory
Tax ID family
University of Maryland Community Medical Group Inc171 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 21

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1711324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711324800000",
    "number": "1033969142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 ELKRIDGE LANDING RD FL 2",
            "city": "LINTHICUM",
            "state": "MD",
            "postal_code": "210902924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2540 CENTREVILLE RD",
            "city": "CENTREVILLE",
            "state": "MD",
            "postal_code": "216172681",
            "telephone_number": "410-758-4432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF MARYLAND COMMUNITY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-25",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-23",
        "status": "A",
        "authorized_official_last_name": "NICHOLSON",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "STEPHEN",
        "authorized_official_title_or_position": "AO",
        "authorized_official_telephone_number": "410-337-1602"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centreville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.