Organization Active NPI

Family Medical Associates, LLC

  • Family Medicine Physician
  • Woodbine, MD
National Provider Identifier
1225226046
Registry record updated Oct 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
R069707 Issued in MD
Legal business name
FAMILY MEDICAL ASSOCIATES, LLC
Practice address
708C Lisbon Center Dr
Woodbine, MD 21797-8600
Phone
(410) 795-7221
Fax
(410) 795-8920
NPI assigned
Oct 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2007

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

Authorized official

Name
Beverly Elliott
Title
Operational Manager
Phone
(410) 876-9785

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X R069707 MD Primary

Addresses

Primary practice location

708C Lisbon Center Dr
Woodbine, MD 21797-8600

Mailing address

332 140 Village Rd
#167
Westminster, MD 21157-6196
Phone (410) 876-9785

National Provider Directory

National Provider Directory

Locations

332 140 Village Rd
#167
Westminster, MD 21157

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1191542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191542400000",
    "number": "1225226046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 140 VILLAGE RD",
            "address_2": "#167",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211576196",
            "telephone_number": "410-876-9785",
            "fax_number": "410-871-1988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "708C LISBON CENTER DR",
            "city": "WOODBINE",
            "state": "MD",
            "postal_code": "217978600",
            "telephone_number": "410-795-7221",
            "fax_number": "410-795-8920"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-05",
        "last_updated": "2007-10-05",
        "status": "A",
        "authorized_official_last_name": "ELLIOTT",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_title_or_position": "OPERATIONAL MANAGER",
        "authorized_official_telephone_number": "410-876-9785"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "R069707",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbine, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2007; 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.