NPIMap

Organization Active NPI

Shock Trauma Associates, P.a.

  • Prevention Professional
  • Baltimore, MD
National Provider Identifier
1255183000
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prevention ProfessionalTaxonomy code 405300000X
Legal business name
SHOCK TRAUMA ASSOCIATES, P.A.
Practice address
22 S Greene St
Baltimore, MD 21201-1544
Phone
(410) 328-8667
Fax
(443) 462-3129
NPI assigned
Apr 4, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Authorized official

Name
Stacy L Anderson
Title
Reimbursement Manager
Phone
(410) 328-7007

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prevention ProfessionalGroup: 193200000X MULTI-SPECIALTY GROUP 405300000X Primary

Addresses

Primary practice location

22 S Greene St
Baltimore, MD 21201-1544

Mailing address

PO Box 64793
Baltimore, MD 21264-4793
Phone (410) 328-7007

National Provider Directory

National Provider Directory
Tax ID family
Shock Trauma Associates PA2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1712188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712188800000",
    "number": "1255183000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64793",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644793",
            "telephone_number": "410-328-7007",
            "fax_number": "443-462-3129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 S GREENE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011544",
            "telephone_number": "410-328-8667",
            "fax_number": "443-462-3129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHOCK TRAUMA ASSOCIATES, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-04",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "REIMBURSEMENT MANAGER",
        "authorized_official_telephone_number": "410-328-7007"
    },
    "taxonomies": [
        {
            "code": "405300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Prevention Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2024; 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.