Individual provider Active NPI

Sally Elizabeth Sondergaard, MD

  • Obstetrics & Gynecology Physician
  • Owings Mills, MD
National Provider Identifier
1275534299
Registry record updated May 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
D0027136 Issued in MD
Practice address
23 Crossroads Dr
Suite 220
Owings Mills, MD 21117-5420
Phone
(410) 581-9200
Fax
(410) 581-9203
NPI assigned
Aug 2, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X D0027136 MD Primary

Addresses

Primary practice location

23 Crossroads Dr
Suite 220
Owings Mills, MD 21117-5420

Mailing address

23 Crossroads Dr
Suite 220
Owings Mills, MD 21117-5420
Phone (410) 581-9200

Other identifiers 1

IdentifierTypeStateIssuer
811500100MedicaidMD

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20090317000093 MD Practitioner - Obstetrics/Gynecology 1951468040 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0027136MDMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC Obstetrics & Gynecology CurrentSince Feb 2, 2016 Accepting new patients
Privia Medical Group, LLC CurrentSince Feb 2, 2016 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

133 Defense Hwy
Ste 112
Annapolis, MD 21401
Phone (410) 573-0140

23 Crossroads Dr
Ste 220
Owings Mills, MD 21117
Phone (410) 581-9200

11350 Pembrooke Sq
Ste 304
Waldorf, MD 20603
Phone (301) 856-2810

950 N Glebe Rd
Ste 700
Arlington, VA 22203
Phone (484) 228-1065

Organizations & group practices 3

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": "1122940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304380800000",
    "number": "1275534299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 CROSSROADS DR",
            "address_2": "SUITE 220",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175420",
            "telephone_number": "410-581-9200",
            "fax_number": "410-581-9203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 CROSSROADS DR",
            "address_2": "SUITE 220",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175420",
            "telephone_number": "410-581-9200",
            "fax_number": "410-581-9203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONDERGAARD",
        "first_name": "SALLY",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-02",
        "last_updated": "2011-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MD",
            "license": "D0027136",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "811500100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Owings Mills, MD

Sources for this page

Verify at the official NPI Registry.