NPIMap

Organization Active NPI

Luminis Health Medical Group, LLC

  • Family Medicine Physician
  • St Michaels, MD
National Provider Identifier
1164088159
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LUMINIS HEALTH MEDICAL GROUP, LLC
Practice address
1110 S Talbot St Ste 6
St Michaels, MD 21663-2606
Phone
(410) 820-7270
NPI assigned
May 15, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2021

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

Authorized official

Name
Peter Odenwald
Title
Vice President
Phone
(443) 481-6415

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1110 S Talbot St Ste 6
St Michaels, MD 21663-2606

Mailing address

PO Box 12622
Belfast, ME 04915-4017

Other names 1

  • AAMG River Family Physicians Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Anne Arundel Phys Group LLC221 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1110 S Talbot St
Ste 6
St Michaels, MD 21663
Phone (410) 820-7270

NPI Registry JSON

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

{
    "created_epoch": "1557878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621814400000",
    "number": "1164088159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12622",
            "city": "BELFAST",
            "state": "ME",
            "postal_code": "049154017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 S TALBOT ST STE 6",
            "city": "ST MICHAELS",
            "state": "MD",
            "postal_code": "216632606",
            "telephone_number": "410-820-7270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUMINIS HEALTH MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-15",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A",
        "authorized_official_last_name": "ODENWALD",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "443-481-6415"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AAMG River Family Physicians",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "AAMG River Family Physicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Michaels, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; 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.