NPIMap

Organization Active NPI

Maryland Elder Care LLC

  • Internal Medicine Physician
  • Crofton, MD
National Provider Identifier
1063147395
Registry record updated Jul 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MARYLAND ELDER CARE LLC
Practice address
2131 Davidsonville Rd
Crofton, MD 21114-1632
Phone
(410) 507-7617
NPI assigned
Jul 20, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2023

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

Authorized official

Name
Megan Grey, CRNPNPI 1730506304
Title
Owner
Phone
(410) 995-7439

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Adult Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LA2200X

Addresses

Primary practice location

2131 Davidsonville Rd
Crofton, MD 21114-1632

Mailing address

542 Fairmount Rd
Linthicum, MD 21090-2842
Phone (410) 995-7439

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220907000008 MD Part B Supplier - Clinic/Group Practice 8628452836 Receives reassigned benefits from 6 practitioners
Practice locations: Annapolis, MD; Arnold, MD; Crofton, MD; Gambrills, MD; Severna Park, MD

National Provider Directory

National Provider Directory
Tax ID family
Maryland Elder Care LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 6

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": "1658275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690243200000",
    "number": "1063147395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "542 FAIRMOUNT RD",
            "city": "LINTHICUM",
            "state": "MD",
            "postal_code": "210902842",
            "telephone_number": "410-995-7439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2131 DAVIDSONVILLE RD",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211141632",
            "telephone_number": "410-507-7617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND ELDER CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-07-20",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A",
        "authorized_official_last_name": "GREY",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-995-7439",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crofton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.