NPIMap

Organization Active NPI

Medical Mall Services of Maryland, LLC

  • Health Service Clinic/Center
  • Cheverly, MD
National Provider Identifier
1124398086
Registry record updated Jan 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
MEDICAL MALL SERVICES OF MARYLAND, LLC
Practice address
3001 Hospital Dr
Cheverly, MD 20785-1189
Phone
(202) 459-4766
NPI assigned
Jan 10, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2012

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

Authorized official

Name
Mr. James Clayton Bardwell
Title
Chief Financial Officer
Phone
(202) 459-4766

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

3001 Hospital Dr
Cheverly, MD 20785-1189

Mailing address

8201 Corporate Dr
Suite 500
Hyattsville, MD 20785-2230
Phone (202) 459-4766

Other names 1

  • Medical Mall Health Services Doing business as

National Provider Directory

National Provider Directory

Locations

3001 Hospital Dr
#1
Cheverly, MD 20785
Phone (301) 618-2000

8201 Corporate Dr
Ste 500
Landover, MD 20785

Practitioners & affiliated clinicians

Practitioners 4

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": "1326153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326153600000",
    "number": "1124398086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8201 CORPORATE DR",
            "address_2": "SUITE 500",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207852230",
            "telephone_number": "202-459-4766",
            "fax_number": "877-852-6352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 HOSPITAL DR",
            "city": "CHEVERLY",
            "state": "MD",
            "postal_code": "207851189",
            "telephone_number": "202-459-4766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL MALL SERVICES OF MARYLAND, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-10",
        "last_updated": "2012-01-10",
        "status": "A",
        "authorized_official_last_name": "BARDWELL",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "CLAYTON",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "202-459-4766",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medical Mall Health Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cheverly, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2012; 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.