Individual provider Active NPI

Philander Bowen Briscoe, M.D.

  • Otolaryngology Physician
  • Bel Air, MD
National Provider Identifier
1114098332
Registry record updated Sep 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
D0001318 Issued in MD
Practice address
520 Upper Chesapeake Dr
Suite 206
Bel Air, MD 21014-4339
Phone
(410) 879-9100
Fax
(410) 879-0227
NPI assigned
Nov 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X D0001318 MD Primary

Addresses

Primary practice location

520 Upper Chesapeake Dr
Suite 206
Bel Air, MD 21014-4339

Mailing address

520 Upper Chesapeake Dr
Suite 206
Bel Air, MD 21014-4339
Phone (410) 879-9100

Other identifiers 10

IdentifierTypeStateIssuer
5391OtherMDHELIX
25164OtherMDEHP
39909003OtherMDCAREFIRST
103438OtherMDKAISER
P00282834OtherMDRAILROAD MEDICARE
026031200MedicaidMD
317866OtherMDMAMSI
3529111OtherMDAETNA HMO
4328636OtherMDAETNA PPO
E5130010OtherDCCAREFIRST BLUECHOICE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0001318MDMDOtolaryngology Physician

NPI Registry JSON

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

{
    "created_epoch": "1163116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285286400000",
    "number": "1114098332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 UPPER CHESAPEAKE DR",
            "address_2": "SUITE 206",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210144339",
            "telephone_number": "410-879-9100",
            "fax_number": "410-879-0227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 UPPER CHESAPEAKE DR",
            "address_2": "SUITE 206",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210144339",
            "telephone_number": "410-879-9100",
            "fax_number": "410-879-0227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRISCOE",
        "first_name": "PHILANDER",
        "middle_name": "BOWEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-10",
        "last_updated": "2010-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MD",
            "license": "D0001318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HELIX",
            "identifier": "5391",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EHP",
            "identifier": "25164",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "39909003",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER",
            "identifier": "103438",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00282834",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "026031200",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "317866",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "3529111",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "4328636",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BLUECHOICE",
            "identifier": "E5130010",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bel Air, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2010; 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.