NPIMap

Organization Active NPI

Atlantic Physician Services of Maryland, PC

  • Physician Assistant
  • Baltimore, MD
National Provider Identifier
1174632376
Registry record updated Nov 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Legal business name
ATLANTIC PHYSICIAN SERVICES OF MARYLAND, PC
Practice address
5601 Loch Raven Blvd
Baltimore, MD 21239-2905
Phone
(410) 532-4040
Fax
(410) 532-4962
NPI assigned
Aug 30, 2006
Last updated
Nov 2, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2009

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

Authorized official

Name
James J. Flowers, DO
Title
President
Phone
(856) 686-4300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary

Addresses

Primary practice location

5601 Loch Raven Blvd
Baltimore, MD 21239-2905

Mailing address

PO Box 8526
Lancaster, PA 17604-8526
Phone (856) 686-4316

Other identifiers 1

IdentifierTypeStateIssuer
CG0402OtherMDRR MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040212000917 MD Part B Supplier - Clinic/Group Practice 5193619765 Receives reassigned benefits from 13 practitioners
Practice locations: Wilmington, DE

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Locations

334 Main St
Scranton, PA 18519
Phone (570) 307-1767

Practitioners & affiliated clinicians

Practitioners 392

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.

View all 392

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257120000000",
    "number": "1174632376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8526",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176048526",
            "telephone_number": "856-686-4316",
            "fax_number": "856-848-1431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 LOCH RAVEN BLVD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212392905",
            "telephone_number": "410-532-4040",
            "fax_number": "410-532-4962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC PHYSICIAN SERVICES OF MARYLAND, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2009-11-02",
        "status": "A",
        "authorized_official_last_name": "FLOWERS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "856-686-4300",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CG0402",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.