NPIMap

Organization Active NPI

Eye Physicians of St Mary's

  • Optometrist
  • Charlotte Hall, MD
National Provider Identifier
1063737203
Registry record updated Mar 31, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
EYE PHYSICIANS OF ST MARY'S
Practice address
37767 Market Street
Charlotte Hall, MD 20622-3188
Phone
(218) 830-9991
NPI assigned
Mar 31, 2010
Last updated
Mar 31, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
ST. MARY'S HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 31, 2010

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

Authorized official

Name
Richard Braam
Title
Cfo
Phone
(215) 830-9991

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

37767 Market Street
Charlotte Hall, MD 20622-3188

Mailing address

PO Box 20431
Baltimore, MD 21284-0431

National Provider Directory

National Provider Directory
Tax ID family
St Mary's Hospital Specialists12 organizations share this tax ID, including this one
Part of
St Mary's Hospital Specialists

Other organizations with this tax ID 11

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

NPI Registry JSON

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

{
    "created_epoch": "1269993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269993600000",
    "number": "1063737203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 20431",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212840431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37767 MARKET STREET",
            "city": "CHARLOTTE HALL",
            "state": "MD",
            "postal_code": "206223188",
            "telephone_number": "218-830-9991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE PHYSICIANS OF ST MARY'S",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. MARY'S HOSPITAL",
        "enumeration_date": "2010-03-31",
        "last_updated": "2010-03-31",
        "status": "A",
        "authorized_official_last_name": "BRAAM",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "215-830-9991"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte Hall, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2010; 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.