NPIMap

Organization Active NPI

University of Maryland Community Medical Group, Inc.

  • Family Medicine Physician
  • Denton, MD
National Provider Identifier
1053166512
Registry record updated Apr 18, 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
1140 Blades Farm Rd Ste 101
Denton, MD 21629-3488
Phone
(410) 479-5900
NPI assigned
Apr 18, 2024
Last updated
Apr 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 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 Physician 207Q00000X NU Primary

Addresses

Primary practice location

1140 Blades Farm Rd Ste 101
Denton, MD 21629-3488

Mailing address

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

National Provider Directory

National Provider Directory
Tax ID family
University of Maryland Community Medical Group Inc173 organizations share this tax ID, including this one

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.

View all 24

Locations

1140 Blades Farm Rd
Ste 101
Denton, MD 21629
Phone (410) 479-3510

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1713398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713398400000",
    "number": "1053166512",
    "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": "1140 BLADES FARM RD STE 101",
            "city": "DENTON",
            "state": "MD",
            "postal_code": "216293488",
            "telephone_number": "410-479-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF MARYLAND COMMUNITY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-18",
        "last_updated": "2024-04-18",
        "certification_date": "2024-04-18",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denton, MD

Sources for this page

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

Verify at the official NPI Registry.