Luminis Health Medical Group, LLC
Organization Active NPI Neurology Physician · Chester, MD
NPI 1073902888 · NPPES record last updated May 21, 2021
Key facts
- NPI
- 1073902888
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Neurology Physician 2084N0400X
- Legal business name
- LUMINIS HEALTH MEDICAL GROUP, LLC
- Practice address
- 1630 Main St
Chester, MD 21619-2791 - Phone
- (443) 481-1940
- Fax
- (443) 481-1941
- NPI assigned
- Jan 16, 2015
- Organization subpart
- No
Authorized official
- Name
- Stephen Clarke
- Title
- Vice President
- Phone
- (443) 481-6476
Corporate family (same tax ID) 24
Practitioners 4
-
Curtis Foy, M.D.
-
Doris Allen Tate, CRNP, CDE
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050317000146 | MD | Part B Supplier - Clinic/Group Practice | 2860447315 |
Receives reassigned benefits from 897 practitioners This NPI is an additional NPI on the enrollment |
National Provider Directory
- Tax ID family
- Anne Arundel Phys Group LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician |
2084N0400X | Yes |
Addresses
Primary practice location
1630 Main St
Chester, MD 21619-2791
Mailing address
PO Box 12622
Belfast, ME 04915-4017
Phone (443) 481-6467
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 124015300 | Medicaid | MD |
Other names
- Anne Arundel Medical Group - Neurology Specialists
Other providers in Chester, MD
- Andrew Jonathan Larrimore
- Karen L. Levasseur
- LHMG Physical Therapy, LLC
- Luminis Health Imaging, Inc.
- Luminis Health Medical Group, LLC
- Luminis Health Medical Group, LLC
- Luminis Health Medical Group, LLC
- Luminis Health Medical Group, LLC
- Luminis Health Medical Group, LLC
- Luminis Health Medical Group, LLC
All providers in Chester, MD · Neurology Physician in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 21, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.