Von Maurice Homer, BOCPD

Primary specialty

PodiatristTaxonomy code 213E00000X

License

C36341 Issued in MD

Practice address

17 Mission Wood Way
Reisterstown, MD 21136-3651

Phone

(302) 983-9705

Fax

(866) 443-2024

NPI assigned

Jan 22, 2009

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1232582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232582400000",
    "number": "1083852552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 MISSION WOOD WAY",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211363651",
            "telephone_number": "302-983-9705",
            "fax_number": "866-443-2024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 MISSION WOOD WAY",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211363651",
            "telephone_number": "302-983-9705",
            "fax_number": "866-443-2024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOMER",
        "first_name": "VON",
        "middle_name": "MAURICE",
        "name_prefix": "Mr.",
        "credential": "BOCPD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-01-22",
        "last_updated": "2009-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MD",
            "license": "C36341",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "MD",
            "license": "C36341",
            "primary": true
        },
        {
            "code": "213ES0000X",
            "taxonomy_group": "",
            "desc": "Podiatrist, Sports Medicine",
            "state": "MD",
            "license": "C36341",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Podiatrist in Reisterstown, MD
• Providers in Reisterstown, MD by specialty
• Podiatrist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2009; 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.