Braddock Medical Group

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

License

830420 Issued in MD

Legal business name

BRADDOCK MEDICAL GROUP

Practice address

912 Seton Dr
Cumberland, MD 21502-1818

Phone

(301) 722-3111

Fax

(301) 722-5135

NPI assigned

Oct 26, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Thomas E Chappell, MD

Title

Medical Director

Phone

(301) 722-3111

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Braddock Medical Group Laboratory Other name

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Tax ID family

Braddock Medical Group2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Braddock Medical Group P.a.

  • Primary Care Clinic/Center
  • Cumberland, MD
  • NPI 1710980081
  NPD tax ID

Locations

Practitioners 1

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

• Paul Taylor Livengood, MD

  • Family Medicine Physician
  • Cumberland, MD
  • NPI 1275598120
  NPD (past)

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221523200000",
    "number": "1104901313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 SETON DR",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215021818",
            "telephone_number": "301-722-3111",
            "fax_number": "301-722-5135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "912 SETON DR",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215021818",
            "telephone_number": "301-722-3111",
            "fax_number": "301-722-5135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADDOCK MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2008-09-16",
        "status": "A",
        "authorized_official_last_name": "CHAPPELL",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "301-722-3111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MD",
            "license": "830420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0011509001",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Braddock Medical Group Laboratory",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Dee Dee Bower, RN,BSN,IBCLC,RNC-OB
• Bowmans Addition Volunteer Fire Company Inc
• Jackie Lynn Bowser, P.T.A.
• Duane E Boyd
• Robert B Boyle, MPT
• Braddock Medical Group P.a.
• Montana Bradley, DPT
• Frank Breitfeller, D.D.S.
• Brian G Dowling DPM PC
• Brian G. Dowling DPM PC

• Clinical Medical Laboratory in Cumberland, MD
• Providers in Cumberland, MD by specialty
• Clinical Medical Laboratory in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.