Medstar Surgery Center at Brandywine, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

MEDSTAR SURGERY CENTER AT BRANDYWINE, LLC

Practice address

13950 Brandywine Road
Suite 100
Brandywine, MD 20613

Phone

(972) 763-3893

Fax

(972) 692-6745

NPI assigned

Feb 4, 2016

Last updated

Feb 4, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jenetha D Moran

Title

Officer / Authorized Official

Phone

(972) 763-3893

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1454544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454544000000",
    "number": "1053779116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15305 DALLAS PKWY",
            "address_2": "SUITE 1600",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750014637",
            "telephone_number": "972-763-3893",
            "fax_number": "972-692-6745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13950 BRANDYWINE ROAD",
            "address_2": "SUITE 100",
            "city": "BRANDYWINE",
            "state": "MD",
            "postal_code": "20613",
            "telephone_number": "972-763-3893",
            "fax_number": "972-692-6745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDSTAR SURGERY CENTER AT BRANDYWINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-04",
        "last_updated": "2016-02-04",
        "status": "A",
        "authorized_official_last_name": "MORAN",
        "authorized_official_first_name": "JENETHA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OFFICER / AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "972-763-3893"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Medstar Health at Brandywine (MedStar Health at Brandywine / ENT)
• Medstar Medical Group - Southern Maryland LLC (MedStar Shah Medical Group LLC)
• Medstar Medical Group II LLC
• Medstar Medical Group II LLC
• Medstar Medical Group II LLC
• Medstar Surgery Center at Brandywine, LLC
• Metro Medical Supply LLC
• Natasha F Mohammed
• Omoro Mojidi
• Ronaldo Montecer Jr., PT

• Ambulatory Surgical Clinic/Center in Brandywine, MD
• Providers in Brandywine, MD by specialty
• Ambulatory Surgical Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2016; 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.