Organization Active NPI

Maryland Chiropractic & Physical Medicine LLC

  • Chiropractor
  • Edgewater, MD
National Provider Identifier
1114403045
Registry record updated Jul 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
S03774 Issued in MD
Legal business name
MARYLAND CHIROPRACTIC & PHYSICAL MEDICINE LLC
Practice address
137 Mitchells Chance Rd Ste 100
Edgewater, MD 21037-2793
Phone
(443) 294-6873
Fax
(443) 294-6874
NPI assigned
Jul 13, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2018

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

Authorized official

Name
Derek Curran, D.C.NPI 1780933143
Title
Owner/Chiropractor
Phone
(443) 294-6873

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X S03774 MD Primary

Addresses

Primary practice location

137 Mitchells Chance Rd Ste 100
Edgewater, MD 21037-2793

Mailing address

137 Mitchells Chance Rd Ste 100
Edgewater, MD 21037-2793

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180920000476 MD Part B Supplier - Clinic/Group Practice 6305197963 Receives reassigned benefits from 2 practitioners
Practice locations: Edgewater, MD

National Provider Directory

National Provider Directory

Locations

137 Mitchells Chance Rd
Ste 100
Edgewater, MD 21037
Phone (443) 294-6873

Practitioners & affiliated clinicians

Practitioners 2

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": "1531440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531440000000",
    "number": "1114403045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "137 MITCHELLS CHANCE RD STE 100",
            "city": "EDGEWATER",
            "state": "MD",
            "postal_code": "210372793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 MITCHELLS CHANCE RD STE 100",
            "city": "EDGEWATER",
            "state": "MD",
            "postal_code": "210372793",
            "telephone_number": "443-294-6873",
            "fax_number": "443-294-6874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND CHIROPRACTIC & PHYSICAL MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-13",
        "last_updated": "2018-07-13",
        "status": "A",
        "authorized_official_last_name": "CURRAN",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "443-294-6873",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "S03774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewater, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2018; 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.