Organization Active NPI

Harford Mobile Medicine LLC

  • Family Medicine Physician
  • Forest Hill, MD
National Provider Identifier
1043910136
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
HARFORD MOBILE MEDICINE LLC
Practice address
1501 Morse Rd
Forest Hill, MD 21050-1003
Phone
(443) 243-9371
NPI assigned
Mar 7, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Christine O Newsome, CRNPNPI 1609107556
Title
Owner
Phone
(443) 243-9371

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1501 Morse Rd
Forest Hill, MD 21050-1003

Mailing address

1501 Morse Rd
Forest Hill, MD 21050-1003
Phone (443) 243-9371

Other identifiers 2

IdentifierTypeStateIssuer
1609107556MedicaidMD
R152794OtherMDMARYLAND BOARD OF NURSING

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230415000028 MD Part B Supplier - Clinic/Group Practice 2567837065 Receives reassigned benefits from 1 practitioner
Practice locations: Forest Hill, MD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1678147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1043910136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 MORSE RD",
            "city": "FOREST HILL",
            "state": "MD",
            "postal_code": "210501003",
            "telephone_number": "443-243-9371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 MORSE RD",
            "city": "FOREST HILL",
            "state": "MD",
            "postal_code": "210501003",
            "telephone_number": "443-243-9371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARFORD MOBILE MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-07",
        "last_updated": "2023-03-07",
        "certification_date": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "NEWSOME",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-243-9371",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609107556",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARYLAND BOARD OF NURSING",
            "identifier": "R152794",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hill, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.