Clearway Surgery Center of Frederick LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

CLEARWAY SURGERY CENTER OF FREDERICK LLC

Practice address

7100 Guilford Dr Ste 152
Frederick, MD 21704-5257

Phone

(855) 527-7246

Fax

(866) 229-5063

NPI assigned

Mar 29, 2022

Organization subpart

No

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

Authorized official

Name

Ira Kornbluth, M.D.

Title

President

Phone

(855) 527-7246

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Ambulatory surgical center certification: CCN 21C0001664

Legal name

Clearway Surgery Center of Frederick, LLC

Certification status

Active

Provider type (POS)

Ambulatory surgical center

Participating since

Jul 18, 2023

Last certification

Jul 18, 2023

Facility address

7100 Guilford Drive, Suite 152
Frederick, MD 21704

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Inai Meggin Mkandawire, D.O.

  • Physical Medicine & Rehabilitation Physician
  • Owings Mills, MD
  • NPI 1952513988
  NPD (past)

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

{
    "created_epoch": "1648512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1648512000000",
    "number": "1184364333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 DEFENSE HWY STE 205",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017096",
            "telephone_number": "855-527-7246",
            "fax_number": "866-229-5063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7100 GUILFORD DR STE 152",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217045257",
            "telephone_number": "855-527-7246",
            "fax_number": "866-229-5063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEARWAY SURGERY CENTER OF FREDERICK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-29",
        "last_updated": "2022-03-29",
        "certification_date": "2022-03-29",
        "status": "A",
        "authorized_official_last_name": "KORNBLUTH",
        "authorized_official_first_name": "IRA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "855-527-7246",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Genevieve Clarke, RDN, LDN, CDCES
• Brandi Clayton
• Clear Waters Counseling
• Clearview Communities, LLC
• Clearway Anesthesia Services NE LLC
• Kristy Lynn Cleaver, M.P.T.
• Connie Clegg, RN, CRNP
• Risa Clem, MS, CCC-SLP
• Matthew Clementson, DPT
• Hilary D Cleveland, MS, LGPC

• Ambulatory Surgical Clinic/Center in Frederick, MD
• Providers in Frederick, MD by specialty
• Ambulatory Surgical Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.