NPIMap

Organization Active NPI

ASC Development Company, LLC

  • Ambulatory Surgical Clinic/Center
  • Frederick, MD
National Provider Identifier
1093757379
Registry record updated Dec 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
ASC DEVELOPMENT COMPANY, LLC
Practice address
75 Thomas Johnson Dr
Ste C
Frederick, MD 21702-4895
Phone
(301) 620-0012
Fax
(301) 620-9687
NPI assigned
Jun 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2025

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

Authorized official

Name
Shaneka Tinch
Title
RCM Manager
Phone
(469) 458-9222

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

75 Thomas Johnson Dr
Ste C
Frederick, MD 21702-4895

Mailing address

PO Box 931606
Atlanta, GA 31193-1606

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060712000357 MD Part B Supplier - Ambulatory Surgical Center 2163435272 1 other NPI on this enrollment
Practice locations: Frederick, MD

Other NPIs with the same Medicare PAC ID 9

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
ASC Development Company LLCCCN 21C0001436
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory
Tax ID family
ASC Development Company LLC10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

Locations

75 Thomas Johnson Dr
Ste C
Frederick, MD 21702
Phone (301) 620-0012

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1765152000000",
    "number": "1093757379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 931606",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "311931606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 THOMAS JOHNSON DR",
            "address_2": "STE C",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024895",
            "telephone_number": "301-620-0012",
            "fax_number": "301-620-9687"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASC DEVELOPMENT COMPANY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "status": "A",
        "authorized_official_last_name": "TINCH",
        "authorized_official_first_name": "SHANEKA",
        "authorized_official_title_or_position": "RCM MANAGER",
        "authorized_official_telephone_number": "469-458-9222"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.