Glen Burnie MD Endoscopy ASC LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

GLEN BURNIE MD ENDOSCOPY ASC LLC

Doing business as

EndoCentre at Quarterfield Station

Practice address

7704 Quarterfield Rd Ste a
Glen Burnie, MD 21061-4412

Phone

(410) 863-4899

Fax

(410) 863-4895

NPI assigned

Jan 22, 2008

Organization subpart

No

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

Authorized official

Name

Mr. Jeffrey Snodgrass

Title

President

Phone

(615) 665-1283

Specialties & licenses 1

Addresses

Other names 1

• EndoCentre at Quarterfield Station Doing business as

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Listed as

Endocentre at Quarterfield StationCCN 21C0001377

Medicare certification status

ActiveFrom the Provider of Services file

Locations

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

{
    "created_epoch": "1200960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661385600000",
    "number": "1205013273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1A BURTON HILLS BLVD # L&C",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372156187",
            "telephone_number": "615-665-1283",
            "fax_number": "615-234-1720"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7704 QUARTERFIELD RD STE A",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210614412",
            "telephone_number": "410-863-4899",
            "fax_number": "410-863-4895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLEN BURNIE MD ENDOSCOPY ASC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-22",
        "last_updated": "2022-08-25",
        "certification_date": "2022-08-25",
        "status": "A",
        "authorized_official_last_name": "SNODGRASS",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-665-1283",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EndoCentre at Quarterfield Station",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "EndoCentre at Quarterfield Station",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stephanie K Glassman, PSY.D.
• Stephanie Gleason
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• Ambulatory Surgical Clinic/Center in Glen Burnie, MD
• Providers in Glen Burnie, 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 Aug 25, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.