NPIMap

Organization Active NPI

Chester River Health Center

Doing business as Chestertown Vascular Services

  • Clinic/Center
  • Chestertown, MD
National Provider Identifier
1114290293
Registry record updated Feb 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
14022 Issued in MD
Legal business name
CHESTER RIVER HEALTH CENTER
Doing business as
Chestertown Vascular Services
Practice address
100 Brown St
Chestertown, MD 21620-1435
Phone
(410) 822-1000
Fax
(410) 822-4958
NPI assigned
Feb 20, 2012
Last updated
Feb 20, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2012

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

Authorized official

Name
Mr. Samuel L Harris
Title
Director, Revenue Cycle Operations
Phone
(410) 822-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 14022 MD Primary

Addresses

Primary practice location

100 Brown St
Chestertown, MD 21620-1435

Mailing address

100 Brown St
Chestertown, MD 21620-1435
Phone (410) 822-1000

Other names 1

  • Chestertown Vascular Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050510000504 MD Part B Supplier - Clinic/Group Practice 0749220671 Receives reassigned benefits from 191 practitioners
3 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Chestertown, MD

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 189

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.

View all 189

NPI Registry JSON

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

{
    "created_epoch": "1329696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329696000000",
    "number": "1114290293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 BROWN ST",
            "city": "CHESTERTOWN",
            "state": "MD",
            "postal_code": "216201435",
            "telephone_number": "410-822-1000",
            "fax_number": "410-822-4958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BROWN ST",
            "city": "CHESTERTOWN",
            "state": "MD",
            "postal_code": "216201435",
            "telephone_number": "410-822-1000",
            "fax_number": "410-822-4958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESTER RIVER HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-20",
        "last_updated": "2012-02-20",
        "status": "A",
        "authorized_official_last_name": "HARRIS",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR, REVENUE CYCLE OPERATIONS",
        "authorized_official_telephone_number": "410-822-1000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MD",
            "license": "14022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chestertown Vascular Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chestertown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.