Active NPI
Gary S Staples, M.D.
- Specialist
- Clinton, MD
National Provider Identifier
1285620401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- D0018817
- Practice address
- 7501 Surratts Rd
Clinton, MD 20735-3362 - Phone
- (301) 870-7001
- Fax
- (301) 870-6697
- NPI assigned
- Sep 22, 2005
- Reactivated
- Mar 22, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | D0018817 | MD | Primary |
Addresses
Primary practice location
7501 Surratts Rd
Clinton, MD 20735-3362
Mailing address
7503 Surratts Rd
Clinton, MD 20735-3358
Phone (301) 870-7001
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0018817 | MD | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southern Radiology MRI Partnership | Past | Accepting new patients | |
| DRS Groover Christie & Merritt PC | Past | Accepting new patients | |
| Southern Maryland Professional Rad | Specialist | Past | Accepting new patients |
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.
-
- Diagnostic Radiology Physician
- Bethesda, MD
- NPI 1902878788
-
- Diagnostic Radiology Physician
- Clinton, MD
- NPI 1922009968
Specialist
-
- Diagnostic Radiology Physician
- Clinton, MD
- NPI 1568463594
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1363910400000",
"number": "1285620401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7503 SURRATTS RD",
"city": "CLINTON",
"state": "MD",
"postal_code": "207353358",
"telephone_number": "301-870-7001",
"fax_number": "301-870-6697"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7501 SURRATTS RD",
"city": "CLINTON",
"state": "MD",
"postal_code": "207353362",
"telephone_number": "301-870-7001",
"fax_number": "301-870-6697"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STAPLES",
"first_name": "GARY",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-22",
"last_updated": "2013-03-22",
"deactivation_date": "2009-09-24",
"reactivation_date": "2013-03-22",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "MD",
"license": "D0018817",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clinton, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.