Active NPI
I C Care Corporation
- Specialist
- Largo, MD
National Provider Identifier
1104845361
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- D31069
- Legal business name
- I C CARE CORPORATION
- Practice address
- 1100 Mercantile LN
Suite #135
Largo, MD 20774-5380 - Phone
- (301) 773-9700
- Fax
- (301) 773-4900
- NPI assigned
- Jul 19, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. George Herbert Bone, M.D.
- Title
- Owner
- Phone
- (301) 773-9700
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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | D31069 | MD | Primary |
| Primary Care Clinic/Center | 261QP2300X |
Addresses
Primary practice location
1100 Mercantile LN
Suite #135
Largo, MD 20774-5380
Mailing address
1100 Mercantile LN
Suite #135
Largo, MD 20774-5380
Phone (301) 773-9700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 409341100 | Medicaid | MD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
Enrollment records 1
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Family Nurse Practitioner
- Washington, DC
- NPI 1134482433
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153267200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1319500800000",
"number": "1104845361",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 MERCANTILE LN",
"address_2": "SUITE #135",
"city": "LARGO",
"state": "MD",
"postal_code": "207745380",
"telephone_number": "301-773-9700",
"fax_number": "301-773-4900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 MERCANTILE LN",
"address_2": "SUITE #135",
"city": "LARGO",
"state": "MD",
"postal_code": "207745380",
"telephone_number": "301-773-9700",
"fax_number": "301-773-4900"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "I C CARE CORPORATION",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-19",
"last_updated": "2011-10-25",
"status": "A",
"authorized_official_last_name": "BONE",
"authorized_official_first_name": "GEORGE",
"authorized_official_middle_name": "HERBERT",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "301-773-9700",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Specialist",
"state": "MD",
"license": "D31069",
"primary": true
},
{
"code": "261QP2300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Primary Care",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "409341100",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Largo, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2011; 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.