Gerald W Adcock Jr.
Individual provider Active NPI Nurse Practitioner · Hagerstown, MD
NPI 1083496970 · NPPES record last updated Oct 16, 2023
Key facts
- NPI
- 1083496970
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- R226749 (MD)
- Practice address
- 11116 Medical Campus Rd
C/O Usacs in Ed
Hagerstown, MD 21742-6710 - Phone
- (240) 674-2774
- NPI assigned
- Oct 16, 2023
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MD, NC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240301003795 | MD | Practitioner - Nurse Practitioner | 5395180152 | Reassigns benefits to 1 organization |
| I20250123002836 | NC | Practitioner - Nurse Practitioner | 5395180152 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0135203 | MD | MD | Paramedic |
| R226749 | MD | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Emergency Medicine Physicians of Carteret County, PLLC | Current |
Accepting new patients | |
| Emergency Medicine Physicians of Craven County, PLLC | Current |
Accepting new patients | |
| Mep Health, LLC | Current |
Accepting new patients |
Locations
12500 Willowbrook Rd
Cumberland, MD 21502
Phone (240) 964-1255
11116 Medical Campus Rd
Hagerstown, MD 21742
Phone (301) 766-7600
3500 Arendell St
Morehead City, NC 28557
Phone (252) 499-6000
2000 Neuse Blvd
New Bern, NC 28560
Phone (252) 633-8104
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | R226749 | MD | |
| Paramedic | 146L00000X | 0135203 | MD | |
| Nurse Practitioner | 363L00000X | R226749 | MD | Yes |
Addresses
Primary practice location
11116 Medical Campus Rd
C/O Usacs in Ed
Hagerstown, MD 21742-6710
Mailing address
209 Woodpoint Ave
Hagerstown, MD 21740-3553
Phone (240) 674-2774
Other providers in Hagerstown, MD
- Ryan Christopher Adams
- Sarah Adams
- Elizabeth Anne Adamson
- Adamu Health Care LLC
- David Adashek
- Adeboye Adekunle
- Sandra Aderhold
- Sando Sherman Adetunji
- Olivia Serwah Adjekum
- Audrey Adkins
All providers in Hagerstown, MD · Nurse Practitioner in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 16, 2023. 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.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.