NPIMap

Organization Active NPI

Seton Medical Group, Inc

  • Internal Medicine Physician
  • Baltimore, MD
National Provider Identifier
1194546721
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
SETON MEDICAL GROUP, INC
Practice address
2801 Foster Avenue
Baltimore, MD 21224-3862
Phone
(410) 342-0333
NPI assigned
Oct 17, 2024
Organization subpart
Yes
Parent organization
ASCENSION HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Authorized official

Name
Mr. William B Higginbotham
Title
President/Ceo
Phone
(667) 234-3162

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

2801 Foster Avenue
Baltimore, MD 21224-3862

Mailing address

2801 Foster Avenue
Baltimore, MD 21224-3862
Phone (410) 342-0333

Other names 1

  • Ascension Saint Agnes Primary Care Canton Other name

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
21D0937427Seton Medical Group2801 Foster Avenue, Baltimore, MD 21224Certificate of waiverDec 15, 2027

National Provider Directory

National Provider Directory
Tax ID family
Ascension Saint Agnes OBGYN Columbia15 organizations share this tax ID, including this one
Part of
Ascension Health

Other organizations with this tax ID 14

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

View all 14

Locations

2801 Foster Ave
Baltimore, MD 21224
Phone (410) 342-0333

NPI Registry JSON

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

{
    "created_epoch": "1729123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730332800000",
    "number": "1194546721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 FOSTER AVENUE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212243862",
            "telephone_number": "410-342-0333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 FOSTER AVENUE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212243862",
            "telephone_number": "410-342-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SETON MEDICAL GROUP, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ASCENSION HEALTH",
        "enumeration_date": "2024-10-17",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A",
        "authorized_official_last_name": "HIGGINBOTHAM",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "667-234-3162",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ascension Saint Agnes Primary Care Canton",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Ascension Saint Agnes Primary Care Canton",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Oct 31, 2024; 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.