Mid-Atlantic of Fairfield, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

02-008 Issued in MD

Legal business name

MID-ATLANTIC OF FAIRFIELD, LLC

Practice address

1454 Fairfield Loop Rd
Crownsville, MD 21032-2006

Phone

(410) 923-6820

Fax

(410) 987-9157

NPI assigned

Feb 9, 2007

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

Mr. Scott Rifkin, M.D.

Title

Ceo

Phone

(410) 308-2300

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285775627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1454 FAIRFIELD LOOP RD",
            "city": "CROWNSVILLE",
            "state": "MD",
            "postal_code": "210322006",
            "telephone_number": "410-923-6820",
            "fax_number": "410-987-9157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1454 FAIRFIELD LOOP RD",
            "city": "CROWNSVILLE",
            "state": "MD",
            "postal_code": "210322006",
            "telephone_number": "410-923-6820",
            "fax_number": "410-987-9157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-ATLANTIC OF FAIRFIELD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RIFKIN",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "410-308-2300",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MD",
            "license": "02-008",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Skilled Nursing Facility in Crownsville, MD
• Providers in Crownsville, MD by specialty
• Skilled Nursing Facility 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.