NPIMap

Organization Active NPI

Meritus Medical Center Inc

Doing business as Meritus Palliative Care

  • Nurse Practitioner
  • Hagerstown, MD
National Provider Identifier
1205176393
Registry record updated Oct 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
MERITUS MEDICAL CENTER INC
Doing business as
Meritus Palliative Care
Practice address
11116 Medical Campus Rd
Room 2999
Hagerstown, MD 21742-6710
Phone
(301) 766-7603
NPI assigned
Feb 26, 2013
Last updated
Oct 26, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
MERITUS MEDICAL CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 26, 2022

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

Authorized official

Name
Mr. Joshua Repac
Title
Cfo
Phone
(301) 790-9351

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X MD Primary

Addresses

Primary practice location

11116 Medical Campus Rd
Room 2999
Hagerstown, MD 21742-6710

Mailing address

11116 Medical Campus Rd
Room 2999
Hagerstown, MD 21742-6710

Other names 1

  • Meritus Palliative Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040212000950 MD Part B Supplier - Clinic/Group Practice 7113811795 Receives reassigned benefits from 320 practitioners
18 other NPIs on this enrollment
Practice locations: Fulton, MD; Ellicott City, MD; Hagerstown, MD; Severna Park, MD; Frederick, MD; Edgewater, MD; Cumberland, MD; Crownsville, MD…

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

National Provider Directory

National Provider Directory
Tax ID family
Washngton Co Hos Ass-Su40 organizations share this tax ID, including this one
Part of
Washngton Co Hos Ass-Su

Other organizations with this tax ID 39

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

View all 39

Locations

11116 Medical Campus Rd
Rm 2999
Hagerstown, MD 21742
Phone (301) 766-7603

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Meritus Home HealthHagerstown, MD, CCN 217085 Home health agency 5% Or Greater Direct Ownership Interest (100%) May 21, 2013

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 434

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 434

NPI Registry JSON

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

{
    "created_epoch": "1361836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666742400000",
    "number": "1205176393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11116 MEDICAL CAMPUS RD",
            "address_2": "ROOM 2999",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217426710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11116 MEDICAL CAMPUS RD",
            "address_2": "ROOM 2999",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217426710",
            "telephone_number": "301-766-7603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERITUS MEDICAL CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERITUS MEDICAL CENTER INC",
        "enumeration_date": "2013-02-26",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A",
        "authorized_official_last_name": "REPAC",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "301-790-9351",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Meritus Palliative Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Meritus Palliative Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hagerstown, MD

Sources for this page

Verify at the official NPI Registry.