Southern Maryland Orthopaedic & Sports Medici NE Center PC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

SOUTHERN MARYLAND ORTHOPAEDIC & SPORTS MEDICI NE CENTER PC

Practice address

23000 Moakley St
Suite 102
Leonardtown, MD 20650-2915

Phone

(301) 475-5555

Fax

(301) 475-8535

NPI assigned

Mar 22, 2007

Last updated

Feb 9, 2009By 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

Heidi Mattingly, CMPE

Title

Practice Administrator

Phone

(301) 475-5555

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234137600000",
    "number": "1285750059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23000 MOAKLEY ST",
            "address_2": "SUITE 102",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206502915",
            "telephone_number": "301-475-5555",
            "fax_number": "301-475-8535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23000 MOAKLEY ST",
            "address_2": "SUITE 102",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206502915",
            "telephone_number": "301-475-5555",
            "fax_number": "301-475-8535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN MARYLAND ORTHOPAEDIC & SPORTS MEDICI NE CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2009-02-09",
        "status": "A",
        "authorized_official_last_name": "MATTINGLY",
        "authorized_official_first_name": "HEIDI",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "301-475-5555",
        "authorized_official_credential": "CMPE"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "225731900",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "2878",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Sarada Sridhar

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2009; 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.