Individual provider Active NPI

John Barthelow Classen, MD

  • General Practice Physician
  • Edgewater, MD
National Provider Identifier
1215037676
Registry record updated Jun 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
D0052684 Issued in MD
Practice address
3059 Solomons Island Rd
Suite F-2
Edgewater, MD 21037-1433
Phone
(410) 956-3394
Fax
(410) 956-3324
NPI assigned
Sep 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X D0052684 MD
General Practice Physician 208D00000X D0052684 MD Primary

Addresses

Primary practice location

3059 Solomons Island Rd
Suite F-2
Edgewater, MD 21037-1433

Mailing address

3637 Rockdale Rd
Manchester, MD 21102-2617
Phone (410) 377-8526

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
MNR Industries,LLC CurrentSince Aug 28, 2021 Accepting new patients
MNR Industries LLC Current Accepting new patients
MNR Industries, LLC CurrentSince Aug 28, 2021 Accepting new patients
MNR Industries, LLC Current Accepting new patients
Medexpress, Inc - Delaware Past Accepting new patients

Locations

1505 E Churchville Rd
#A
Bel Air, MD 21014
Phone (410) 420-6970

504 E Ridgeville Blvd
#A
Mount Airy, MD 21771
Phone (301) 703-5452

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1215037676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3637 ROCKDALE RD",
            "city": "MANCHESTER",
            "state": "MD",
            "postal_code": "211022617",
            "telephone_number": "410-377-8526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3059 SOLOMONS ISLAND RD",
            "address_2": "SUITE F-2",
            "city": "EDGEWATER",
            "state": "MD",
            "postal_code": "210371433",
            "telephone_number": "410-956-3394",
            "fax_number": "410-956-3324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLASSEN",
        "first_name": "JOHN",
        "middle_name": "BARTHELOW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MD",
            "license": "D0052684",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MD",
            "license": "D0052684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewater, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2021; 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.