NPIMap

Organization Active NPI

Carroll Footworks Surgery Center ,LLC

  • Ambulatory Surgical Clinic/Center
  • Reisterstown, MD
National Provider Identifier
1124136437
Registry record updated Sep 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
A1428 Issued in MD
Legal business name
CARROLL FOOTWORKS SURGERY CENTER ,LLC
Practice address
4 Glyndon Dr
Suite 2 a
Reisterstown, MD 21136-2000
Phone
(410) 795-2155
Fax
(410) 795-2154
NPI assigned
Aug 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2009

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

Authorized official

Name
Dr. Annette Joyce, D.P.M.NPI 1316997471
Title
Director
Phone
(410) 795-2155

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
Ambulatory Surgical Clinic/Center 261QA1903X A1428 MD Primary

Addresses

Primary practice location

4 Glyndon Dr
Suite 2 a
Reisterstown, MD 21136-2000

Mailing address

4 Glyndon Dr
Suite 2 a
Reisterstown, MD 21136-2000
Phone (410) 795-2155

Other identifiers 3

IdentifierTypeStateIssuer
7469894OtherMDAETNA PPO
070OtherMDGHMSI
1410709OtherMDAETNA HMO

Other names 1

  • Glyndon Ambulatory Surgery Center Doing business as

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

4 Glyndon Dr
Ste 2A
Reisterstown, MD 21136
Phone (410) 795-2155

Practitioners & affiliated clinicians

Practitioners 6

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": "1156636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251849600000",
    "number": "1124136437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 GLYNDON DR",
            "address_2": "SUITE 2 A",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211362000",
            "telephone_number": "410-795-2155",
            "fax_number": "410-795-2154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 GLYNDON DR",
            "address_2": "SUITE 2 A",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211362000",
            "telephone_number": "410-795-2155",
            "fax_number": "410-795-2154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARROLL FOOTWORKS SURGERY CENTER ,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-27",
        "last_updated": "2009-09-02",
        "status": "A",
        "authorized_official_last_name": "JOYCE",
        "authorized_official_first_name": "ANNETTE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "410-795-2155",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MD",
            "license": "A1428",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "7469894",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHMSI",
            "identifier": "070",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "1410709",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Glyndon Ambulatory Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Reisterstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2009; 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.