Eleanor Court Faherty, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

D74200 Issued in MD

Practice address

11340 Pembrooke SQ Ste 202
Waldorf, MD 20603-4808

Phone

(410) 328-7320

Fax

(410) 328-5919

NPI assigned

Feb 20, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Dr. Eleanor Marie Court Former name

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• University of Maryland Surgical Associates, PA

  • Specialist
  • Baltimore, MD
  • NPI 1962417634
  Medicare reassignment NPD
• University of Maryland Community Medical Group, Inc.

  • Family Medicine Physician
  • Baltimore, MD
  • NPI 1477530624
  Medicare reassignment
• Civista Clinical Services, LLC

  • Surgery Physician
  • La Plata, MD
  • NPI 1710247440
  NPD (past)

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

{
    "created_epoch": "1203465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1265600522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64226",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212647559",
            "telephone_number": "410-328-7320",
            "fax_number": "410-328-5919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11340 PEMBROOKE SQ STE 202",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206034808",
            "telephone_number": "410-328-7320",
            "fax_number": "410-328-5919"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6215 Hampstead Court",
            "address_purpose": "LOCATION",
            "city": "Port Tobacco",
            "state": "MD",
            "postal_code": "20677",
            "country_code": "US",
            "telephone_number": "202-302-3345",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6215 Hampstead Court",
            "address_purpose": "LOCATION",
            "city": "Port Tobacco",
            "state": "MD",
            "postal_code": "20677",
            "country_code": "US",
            "telephone_number": "202-302-3345",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FAHERTY",
        "first_name": "ELEANOR",
        "middle_name": "COURT",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-20",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MD",
            "license": "D74200",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "VA",
            "license": "0101242982",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELEANOR",
            "last_name": "COURT",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Surgery Physician in Waldorf, MD
• Providers in Waldorf, MD by specialty
• Surgery Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.