NPIMap

Organization Active NPI

MNR Industries, LLC

Doing business as ExpressCare of Severna Park

  • Urgent Care Clinic/Center
  • Severna Park, MD
National Provider Identifier
1164925202
Registry record updated Jun 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
MNR INDUSTRIES, LLC
Doing business as
ExpressCare of Severna Park
Practice address
153 Ritchie Hwy
Severna Park, MD 21146
Phone
(410) 544-0571
Fax
(410) 544-0574
NPI assigned
Mar 15, 2018
Last updated
Jun 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2024

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

Authorized official

Name
Steven Fisher
Title
Director, Revenue Cycle
Phone
(410) 420-6970

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X NU Primary

Addresses

Primary practice location

153 Ritchie Hwy
Severna Park, MD 21146

Mailing address

1505 E Churchville Rd
Bel Air, MD 21014-4742
Phone (410) 420-6970

Other names 1

  • ExpressCare of Severna Park Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050204000088 MD Part B Supplier - Clinic/Group Practice 7416908843 Receives reassigned benefits from 138 practitioners
34 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Gambrills, MD; Hanover, MD; Hagerstown, MD; Hampstead, MD; Largo, MD; Laurel, MD; Loch Raven, MD; Middle River, MD…

Other NPIs on the same Medicare enrollment 33

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 33

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D2142065Expresscare of Severna Park153 Ritchie Highway, Severna Park, MD 21146Certificate of waiverJan 2, 2028

National Provider Directory

National Provider Directory
Tax ID family
MNR Industries LLC16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1521072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719100800000",
    "number": "1164925202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 E CHURCHVILLE RD",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210144742",
            "telephone_number": "410-420-6970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 RITCHIE HWY",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "21146",
            "telephone_number": "410-544-0571",
            "fax_number": "410-544-0574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MNR INDUSTRIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-15",
        "last_updated": "2024-06-23",
        "certification_date": "2024-06-23",
        "status": "A",
        "authorized_official_last_name": "FISHER",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "DIRECTOR, REVENUE CYCLE",
        "authorized_official_telephone_number": "410-420-6970"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ExpressCare of Severna Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Severna Park, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.