NPIMap

Organization Active NPI

Jarrett Corporation

Doing business as Frederick Family Medical Clinic

  • Primary Care Clinic/Center
  • Frederick, MD
National Provider Identifier
1285006288
Registry record updated Jul 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
D0076463 Issued in MD
Legal business name
JARRETT CORPORATION
Doing business as
Frederick Family Medical Clinic
Practice address
45 Waverley Dr
Suite O
Frederick, MD 21702-4854
Phone
(301) 624-5999
Fax
(301) 624-5997
NPI assigned
Oct 29, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2016

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

Authorized official

Name
Dr. Innocent Monya-Tambi, M.D.
Title
Attending Physician
Phone
(443) 370-5348

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X D0076463 MD Primary

Addresses

Primary practice location

45 Waverley Dr
Suite O
Frederick, MD 21702-4854

Mailing address

45 Waverley Dr
Suite O
Frederick, MD 21702-4854
Phone (301) 624-5999

Other names 1

  • Frederick Family Medical Clinic Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1446076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468540800000",
    "number": "1285006288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 WAVERLEY DR",
            "address_2": "SUITE O",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024854",
            "telephone_number": "301-624-5999",
            "fax_number": "301-624-5997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 WAVERLEY DR",
            "address_2": "SUITE O",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024854",
            "telephone_number": "301-624-5999",
            "fax_number": "301-624-5997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JARRETT CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-29",
        "last_updated": "2016-07-15",
        "status": "A",
        "authorized_official_last_name": "MONYA-TAMBI",
        "authorized_official_first_name": "INNOCENT",
        "authorized_official_title_or_position": "ATTENDING PHYSICIAN",
        "authorized_official_telephone_number": "443-370-5348",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MD",
            "license": "D0076463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Frederick Family Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2016; 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.