NPIMap

Organization Active NPI

Genesis Eldercare Physician Services LLC

  • Geriatric Medicine (Internal Medicine) Physician
  • Towson, MD
National Provider Identifier
1184095267
Registry record updated Apr 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
GENESIS ELDERCARE PHYSICIAN SERVICES LLC
Practice address
515 Fairmount Ave
Towson, MD 21286-5466
Phone
(410) 832-7790
NPI assigned
Oct 14, 2015
Last updated
Apr 13, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2018

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

Authorized official

Name
Eric Shapiro
Title
VP/Controller
Phone
(410) 832-7790

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X NU Primary

Addresses

Primary practice location

515 Fairmount Ave
Towson, MD 21286-5466

Mailing address

PO Box 42738
Towson, MD 21284-2738

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1444780800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1523577600000",
    "number": "1184095267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 42738",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212842738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 FAIRMOUNT AVE",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212865466",
            "telephone_number": "410-832-7790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GENESIS ELDERCARE PHYSICIAN SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-14",
        "last_updated": "2018-04-13",
        "status": "A",
        "authorized_official_last_name": "SHAPIRO",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "VP/CONTROLLER",
        "authorized_official_telephone_number": "410-832-7790"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2018; 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.