NPIMap

Organization Active NPI

Maryland Neurological Center, LLC

  • Neurology Physician
  • Columbia, MD
National Provider Identifier
1205950656
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
MARYLAND NEUROLOGICAL CENTER, LLC
Practice address
11085 Little Patuxent Pkwy
Suite 212
Columbia, MD 21044-2983
Phone
(410) 730-1212
Fax
(410) 730-2812
NPI assigned
Mar 19, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Michael Gearhart
Title
Executive Director
Phone
(410) 730-1212

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

11085 Little Patuxent Pkwy
Suite 212
Columbia, MD 21044-2983

Mailing address

11085 Little Patuxent Pkwy
Suite 212
Columbia, MD 21044-2983
Phone (410) 730-1212

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041122001081 MD Part B Supplier - Clinic/Group Practice 0941265664 Receives reassigned benefits from 1 practitioner
Practice locations: Columbia, MD

National Provider Directory

National Provider Directory

Locations

11085 Little Patuxent Pkwy
Ste 212
Columbia, MD 21044
Phone (410) 730-1212

Practitioners & affiliated clinicians

Practitioners 20

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 20

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1205950656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11085 LITTLE PATUXENT PKWY",
            "address_2": "SUITE 212",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210442983",
            "telephone_number": "410-730-1212",
            "fax_number": "410-730-2812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11085 LITTLE PATUXENT PKWY",
            "address_2": "SUITE 212",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210442983",
            "telephone_number": "410-730-1212",
            "fax_number": "410-730-2812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND NEUROLOGICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GEARHART",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "410-730-1212",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.