Active NPI
University of Maryland Community Medical Group, Inc.
- Family Medicine Physician
- La Plata, MD
National Provider Identifier
1053166314
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- UNIVERSITY OF MARYLAND COMMUNITY MEDICAL GROUP, INC.
- Practice address
- 616 East Charles Street
Suite 102
La Plata, MD 20646-5938 - Phone
- (301) 609-5445
- NPI assigned
- Apr 20, 2024
- Last updated
- Apr 20, 2024
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | Primary |
Addresses
Primary practice location
616 East Charles Street
Suite 102
La Plata, MD 20646-5938
Mailing address
900 Elkridge Landing Rd FL 2
Linthicum, MD 21090-2924
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 21D2330496 | University of Maryland Community Medical Group | Certificate of waiver | Sep 16, 2027 |
National Provider Directory
National Provider Directory- Tax ID family
- University of Maryland Community Medical Group Inc
Organizations with this tax ID in the same state 24
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
- Family Medicine Physician
- La Plata, MD
- NPI 1003661372
-
- Family Medicine Physician
- Glen Burnie, MD
- NPI 1013765981
-
- Family Medicine Physician
- Easton, MD
- NPI 1023863701
-
- Family Medicine Physician
- Arnold, MD
- NPI 1023864709
-
- Family Medicine Physician
- Severna Park, MD
- NPI 1023864717
-
- Family Medicine Physician
- Chestertown, MD
- NPI 1023868437
-
- Pediatrics Physician
- Chestertown, MD
- NPI 1023940343
-
- Pediatrics Physician
- Columbia, MD
- NPI 1023976685
-
- Durable Medical Equipment & Medical Supplies
- Glen Burnie, MD
- NPI 1033042460
-
- Family Medicine Physician
- Centreville, MD
- NPI 1033969142
-
- Family Medicine Physician
- Easton, MD
- NPI 1033969456
-
- Family Medicine Physician
- Chestertown, MD
- NPI 1043060783
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1713571200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1713571200000",
"number": "1053166314",
"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": "616 EAST CHARLES STREET",
"address_2": "SUITE 102",
"city": "LA PLATA",
"state": "MD",
"postal_code": "206465938",
"telephone_number": "301-609-5445"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "UNIVERSITY OF MARYLAND COMMUNITY MEDICAL GROUP, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2024-04-20",
"last_updated": "2024-04-20",
"certification_date": "2024-04-20",
"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": "",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in La Plata, MD
- Umaru Labay-Kamara, MD, LLC (Axios Behavioral Health)
- Cyprian Ike Ume
- Umms Ambulatory Care LLC (University of Maryland Urgent Care- La Plata)
- University of Maryland Charles Regional Urgent Care, LLC
- University of Maryland Community Medical Group, Inc.
- University of Maryland Community Medical Group, Inc.
- University of Maryland Community Medical Group, Inc.
- University of Maryland Community Medical Group, Inc.
- University of Maryland Community Medical Group, Inc.
- University of Maryland Community Medical Group, Inc.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 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.