NPIMap

Organization Active NPI

Medstar Southern Maryland Physicians, LLC

Doing business as MedStar Southern Maryland Vascular and General Surgery

  • Vascular Surgery Physician
  • Clinton, MD
National Provider Identifier
1063880599
Registry record updated Sep 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
MEDSTAR SOUTHERN MARYLAND PHYSICIANS, LLC
Doing business as
MedStar Southern Maryland Vascular and General Surgery
Practice address
7501 Surratts Rd
Suite 208
Clinton, MD 20735-3362
Phone
(301) 877-7353
Fax
(301) 877-5637
NPI assigned
Sep 15, 2015
Last updated
Sep 15, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
MEDSTAR SOUTHERN MARYLAND PHYSICIANS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 15, 2015

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

Authorized official

Name
Jane E Raymond
Title
Associate VP
Phone
(301) 856-3019

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X
Vascular Surgery Physician 2086S0129X Primary

Addresses

Primary practice location

7501 Surratts Rd
Suite 208
Clinton, MD 20735-3362

Mailing address

7501 Surratts Rd
Suite 208
Clinton, MD 20735-3362
Phone (301) 877-7353

Other names 1

  • MedStar Southern Maryland Vascular and General Surgery Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Medstar Southern MD Phys13 organizations share this tax ID, including this one
Part of
Medstar Southern MD Phys

Other organizations with this tax ID 12

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": "1442275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442275200000",
    "number": "1063880599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7501 SURRATTS RD",
            "address_2": "SUITE 208",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207353362",
            "telephone_number": "301-877-7353",
            "fax_number": "301-877-5637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7501 SURRATTS RD",
            "address_2": "SUITE 208",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207353362",
            "telephone_number": "301-877-7353",
            "fax_number": "301-877-5637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDSTAR SOUTHERN MARYLAND PHYSICIANS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDSTAR SOUTHERN MARYLAND PHYSICIANS, LLC",
        "enumeration_date": "2015-09-15",
        "last_updated": "2015-09-15",
        "status": "A",
        "authorized_official_last_name": "RAYMOND",
        "authorized_official_first_name": "JANE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "ASSOCIATE VP",
        "authorized_official_telephone_number": "301-856-3019"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MedStar Southern Maryland Vascular and General Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Clinton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2015; 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.