NPIMap

Organization Active NPI

1St Medical Pain Management Specialists

Doing business as 1st Medical Painrehab Center

  • Multi-Specialty Clinic/Center
  • Oxon Hill, MD
National Provider Identifier
1205501608
Registry record updated Jan 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
1ST MEDICAL PAIN MANAGEMENT SPECIALISTS
Doing business as
1st Medical Painrehab Center
Practice address
5620 Saint Barnabas Rd Ste 340
Oxon Hill, MD 20745-3628
Phone
(301) 747-4224
Fax
(410) 956-6803
NPI assigned
Aug 9, 2021
Last updated
Jan 23, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
1ST MEDICAL OF ANNAPOLIS, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 23, 2022

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

Authorized official

Name
Rosemary Ingado, PHYSICIAN ASSISTANTNPI 1063637155
Title
Clinical Administrator
Phone
(410) 956-6800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X NU
Mental Health Counselor 101YM0800X NU
Clinical Social Worker 1041C0700X NU
Adult Mental Health Clinic/Center 261QM0850X NU
Multi-Specialty Clinic/Center 261QM1300X NU Primary
Pain Clinic/Center 261QP3300X NU
Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X NU
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU
Obesity and Weight Management Nutrition Registered Dietitian 133VN1201X NU

Addresses

Primary practice location

5620 Saint Barnabas Rd Ste 340
Oxon Hill, MD 20745-3628

Mailing address

20 Mayo Rd Ste 201
Edgewater, MD 21037-1442
Phone (410) 956-6800

Other names 1

  • 1st Medical Painrehab Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
1St Medical Pain Management Specialists7 organizations share this tax ID, including this one
Part of
1St Medical of Annapolis

Other organizations with this tax ID 6

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

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1628467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642896000000",
    "number": "1205501608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 MAYO RD STE 201",
            "city": "EDGEWATER",
            "state": "MD",
            "postal_code": "210371442",
            "telephone_number": "410-956-6800",
            "fax_number": "410-956-6803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5620 SAINT BARNABAS RD STE 340",
            "city": "OXON HILL",
            "state": "MD",
            "postal_code": "207453628",
            "telephone_number": "301-747-4224",
            "fax_number": "410-956-6803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "1ST MEDICAL PAIN MANAGEMENT SPECIALISTS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "1ST MEDICAL OF ANNAPOLIS, INC.",
        "enumeration_date": "2021-08-09",
        "last_updated": "2022-01-23",
        "certification_date": "2022-01-23",
        "status": "A",
        "authorized_official_last_name": "INGADO",
        "authorized_official_first_name": "ROSEMARY",
        "authorized_official_title_or_position": "CLINICAL ADMINISTRATOR",
        "authorized_official_telephone_number": "410-956-6800",
        "authorized_official_credential": "PHYSICIAN ASSISTANT"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133VN1201X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "1st Medical Painrehab Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oxon Hill, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2022; 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.