NPIMap

Organization Active NPI

Wellspring Family Medicine, PC

  • Family Medicine Physician
  • Oakland, MD
National Provider Identifier
1194744359
Registry record updated Mar 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D0061801 Issued in MD
Legal business name
WELLSPRING FAMILY MEDICINE, PC
Practice address
311 N 4TH St Ste 1
Oakland, MD 21550-1371
Phone
(301) 334-7855
Fax
(833) 398-2061
NPI assigned
Jul 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2025

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

Authorized official

Name
Shaina Saturday
Title
Cfo
Phone
(301) 334-7855

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X D0061801 MD Primary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X H0064705 MD
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X D0061801 MD
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X H0064705 MD
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X C0001983 MD

Addresses

Primary practice location

311 N 4TH St Ste 1
Oakland, MD 21550-1371

Mailing address

311 N 4TH St
Suite 1
Oakland, MD 21550-1395
Phone (301) 334-7855

Other identifiers 7

IdentifierTypeStateIssuer
3810001034MedicaidWV
001663200MedicaidMD
002509760MedicaidMD
2128112OtherMDMAMSI,ALL,OPT CH,MDIPA
64303201OtherMDBCBS MD
610547800OtherMDFEDERAL BLACK LUNG #
K076-0001OtherMDBCBS DC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, WV2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040929000439 MD Part B Supplier - Clinic/Group Practice 7012986763 Receives reassigned benefits from 13 practitioners
Practice locations: Accident, MD; Oakland, MD
O20160331000339 WV Part B Supplier - Clinic/Group Practice 7012986763 Receives reassigned benefits from 2 practitioners
Practice locations: Terra Alta, WV

National Provider Directory

National Provider Directory

Locations

106 Cemetery Rd
#247
Accident, MD 21520
Phone (301) 746-8627

Practitioners & affiliated clinicians

Practitioners 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743120000000",
    "number": "1194744359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 N 4TH ST",
            "address_2": "SUITE 1",
            "city": "OAKLAND",
            "state": "MD",
            "postal_code": "215501395",
            "telephone_number": "301-334-7855",
            "fax_number": "301-334-7828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 N 4TH ST STE 1",
            "city": "OAKLAND",
            "state": "MD",
            "postal_code": "215501371",
            "telephone_number": "301-334-7855",
            "fax_number": "833-398-2061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WELLSPRING FAMILY MEDICINE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A",
        "authorized_official_last_name": "SATURDAY",
        "authorized_official_first_name": "SHAINA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "301-334-7855"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0061801",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "H0064705",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "MD",
            "license": "D0061801",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "MD",
            "license": "H0064705",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "C0001983",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810001034",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001663200",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002509760",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI,ALL,OPT CH,MDIPA",
            "identifier": "2128112",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MD",
            "identifier": "64303201",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLACK LUNG #",
            "identifier": "610547800",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS DC",
            "identifier": "K076-0001",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.