NPIMap

Organization Active NPI

Seton Medical Group, Inc

  • Internal Medicine Physician
  • Elkridge, MD
National Provider Identifier
1083434617
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SETON MEDICAL GROUP, INC
Practice address
6518 Meadowridge Rd Ste 110
Elkridge, MD 21075-6458
Phone
(667) 234-8650
NPI assigned
Oct 17, 2024
Organization subpart
Yes
Parent organization
ASCENSION HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Authorized official

Name
Mr. William B Higginbotham
Title
President/Ceo
Phone
(667) 234-3162

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X

Addresses

Primary practice location

6518 Meadowridge Rd Ste 110
Elkridge, MD 21075-6458

Mailing address

6518 Meadowridge Rd Ste 110
Elkridge, MD 21075-6458
Phone (667) 234-8650

Other names 1

  • Ascension Saint Agnes Primary Care Elkridge Other name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D2009918Seton Medical Group at Elkridge6518 Meadowridge Road Suite 110, Elkridge, MD 21075Certificate of waiverJul 15, 2028

National Provider Directory

National Provider Directory
Tax ID family
Ascension Saint Agnes OBGYN Columbia15 organizations share this tax ID, including this one
Part of
Ascension Health

Other organizations with this tax ID 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1729123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730332800000",
    "number": "1083434617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6518 MEADOWRIDGE RD STE 110",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210756458",
            "telephone_number": "667-234-8650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6518 MEADOWRIDGE RD STE 110",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210756458",
            "telephone_number": "667-234-8650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SETON MEDICAL GROUP, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ASCENSION HEALTH",
        "enumeration_date": "2024-10-17",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A",
        "authorized_official_last_name": "HIGGINBOTHAM",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "667-234-3162",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ascension Saint Agnes Primary Care Elkridge",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Ascension Saint Agnes Primary Care Elkridge",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Elkridge, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.