Greenridge Health Partners

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

GREENRIDGE HEALTH PARTNERS

Practice address

1300 York Rd
BLDG a Suite 100
Timonium, MD 21093-6016

Phone

(410) 821-9620

Fax

(410) 821-9624

NPI assigned

Feb 15, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Richard Lloyd Trader, PA-C

Title

Director

Phone

(410) 821-9620

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184767162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 YORK ROAD",
            "address_2": "BLDG A SUITE 100",
            "city": "TIMONIUM",
            "state": "MD",
            "postal_code": "210936016",
            "telephone_number": "410-821-9620",
            "fax_number": "410-821-9624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 YORK RD",
            "address_2": "BLDG A SUITE 100",
            "city": "TIMONIUM",
            "state": "MD",
            "postal_code": "210936016",
            "telephone_number": "410-821-9620",
            "fax_number": "410-821-9624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENRIDGE HEALTH PARTNERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TRADER",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "LLOYD",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "410-821-9620",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Timonium, MD
• Providers in Timonium, MD by specialty
• Family Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.