NPIMap

Organization Active NPI

Medical and Wellness Center of Olney

  • Internal Medicine Physician
  • Olney, MD
National Provider Identifier
1104013671
Registry record updated Oct 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0055694 Issued in MD
Legal business name
MEDICAL AND WELLNESS CENTER OF OLNEY
Practice address
4000 Olney-Laytonsville Rd
Olney, MD 20832-1802
Phone
(301) 774-2506
Fax
(301) 774-3734
NPI assigned
Sep 28, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2012

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

Authorized official

Name
Alok Mathur, M.D.NPI 1619035573
Title
Physician/Owner
Phone
(301) 774-2506

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X D0055694 MD Primary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X D0056132 MD
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X D0055931 MD

Addresses

Primary practice location

4000 Olney-Laytonsville Rd
Olney, MD 20832-1802

Mailing address

4000 Olney-Laytonsville Rd
Olney, MD 20832-1802
Phone (301) 774-2506

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080407000315 DC Part B Supplier - Clinic/Group Practice 7810074481 Receives reassigned benefits from 2 practitioners
Practice locations: Olney, MD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1190937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349049600000",
    "number": "1104013671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4000 OLNEY-LAYTONSVILLE RD",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208321802",
            "telephone_number": "301-774-2506",
            "fax_number": "301-774-3734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4000 OLNEY-LAYTONSVILLE RD",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208321802",
            "telephone_number": "301-774-2506",
            "fax_number": "301-774-3734"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL AND WELLNESS CENTER OF OLNEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-28",
        "last_updated": "2012-10-01",
        "status": "A",
        "authorized_official_last_name": "MATHUR",
        "authorized_official_first_name": "ALOK",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "301-774-2506",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0055694",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0056132",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0055931",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olney, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.