Carroll Internal Medicine Associates LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

D31660 Issued in MD

Legal business name

CARROLL INTERNAL MEDICINE ASSOCIATES LLC

Practice address

291 Stoner Ave
Suite 203
Westminster, MD 21157-5647

Phone

(410) 848-2449

Fax

(410) 848-2798

NPI assigned

Nov 6, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Charlotte A Keeney

Title

Practice Manager

Phone

(410) 848-2449

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Simone H Brady, CRNP

  • Family Nurse Practitioner
  • Columbia, MD
  • NPI 1144202383
  NPD (past)

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1275612459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "291 STONER AVE STE 203",
            "address_2": "SUITE 203",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211575659",
            "telephone_number": "410-848-2449",
            "fax_number": "410-848-2798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "291 STONER AVE",
            "address_2": "SUITE 203",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211575647",
            "telephone_number": "410-848-2449",
            "fax_number": "410-848-2798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARROLL INTERNAL MEDICINE ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KEENEY",
        "authorized_official_first_name": "CHARLOTTE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "410-848-2449",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MD",
            "license": "D31660",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MARYLAND",
            "identifier": "KH04CA",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Carroll Health Group, LLC
• Carroll Hospital Center, Inc (Carroll Home Care)
• Carroll Hospital Center, Inc
• Carroll Hospital Center, Inc. (CHC Med lab)
• Carroll Hospital Center, Inc.
• Carroll Lutheran Village Inc
• Carroll Medical Associates, LLC
• Carroll Neurosurgical Associates
• Carroll OBGYN Associates, LTD
• Carroll Occupational Health, LLC

• Specialist in Westminster, MD
• Providers in Westminster, MD by specialty
• Specialist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.