NPIMap

Organization Active NPI

Ummc Midtown Campus

  • Clinical Medical Laboratory
  • Baltimore, MD
National Provider Identifier
1184026478
Registry record updated Sep 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
1057 Issued in MD
Legal business name
UMMC MIDTOWN CAMPUS
Practice address
827 Linden Ave
Baltimore, MD 21201-4606
Phone
(410) 225-8010
Fax
(410) 462-6093
NPI assigned
Sep 18, 2014
Last updated
Sep 18, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2014

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

Authorized official

Name
Mr. Wayne Louis Cvach, RRT,CPFT
Title
Director
Phone
(410) 225-8016

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 1057 MD Primary

Addresses

Primary practice location

827 Linden Ave
Baltimore, MD 21201-4606

Mailing address

827 Linden Ave
Baltimore, MD 21201-4606
Phone (410) 225-8010

Other identifiers 1

IdentifierTypeStateIssuer
1669565180MedicaidMD

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
21D1016734Ummc MTC Center for Addiction Medicine827 Linden Avenue Suite B, Baltimore, MD 21201Certificate of waiverSep 4, 2027

National Provider Directory

National Provider Directory
Tax ID family
Ummc WPCC Carruthers Clinic10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

NPI Registry JSON

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

{
    "created_epoch": "1410998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1410998400000",
    "number": "1184026478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "827 LINDEN AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212014606",
            "telephone_number": "410-225-8010",
            "fax_number": "410-462-6093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "827 LINDEN AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212014606",
            "telephone_number": "410-225-8010",
            "fax_number": "410-462-6093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UMMC MIDTOWN CAMPUS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-18",
        "last_updated": "2014-09-18",
        "status": "A",
        "authorized_official_last_name": "CVACH",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "LOUIS",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "410-225-8016",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RRT,CPFT"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MD",
            "license": "1057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1669565180",
            "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 Sep 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.