NPIMap

Organization Active NPI

Eucentrics Urgent Care and Wellness Center

  • Medical Physician Assistant
  • Frederick, MD
National Provider Identifier
1124423637
Registry record updated Nov 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
C04452 Issued in MD
Legal business name
EUCENTRICS URGENT CARE AND WELLNESS CENTER
Practice address
1100 W Patrick St Ste H
Frederick, MD 21703-3974
Phone
(301) 662-6478
NPI assigned
Oct 27, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2014

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

Authorized official

Name
Randyl Erik Gessel, PA-CNPI 1124285184
Title
President
Phone
(301) 662-6478

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
AcupuncturistGroup: 193200000X MULTI-SPECIALTY GROUP 171100000X U0213 MD
Medical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AM0700X C04452 MD Primary

Addresses

Primary practice location

1100 W Patrick St Ste H
Frederick, MD 21703-3974

Mailing address

1100 W Patrick St Ste H
Frederick, MD 21703-3974
Phone (301) 662-6478

Other identifiers 1

IdentifierTypeStateIssuer
12236488OtherCAQH

National Provider Directory

National Provider Directory

Locations

1100 W Patrick St
Ste H
Frederick, MD 21703
Phone (301) 662-6478

Practitioners & affiliated clinicians

Practitioners 1

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": "1414368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415577600000",
    "number": "1124423637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 W PATRICK ST STE H",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217033974",
            "telephone_number": "301-662-6478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 W PATRICK ST STE H",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217033974",
            "telephone_number": "301-662-6478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EUCENTRICS URGENT CARE AND WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-27",
        "last_updated": "2014-11-10",
        "status": "A",
        "authorized_official_last_name": "GESSEL",
        "authorized_official_first_name": "RANDYL",
        "authorized_official_middle_name": "ERIK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-662-6478",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "171100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Acupuncturist",
            "state": "MD",
            "license": "U0213",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C04452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "12236488",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2014; 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.