Individual provider Active NPI

John Wayne Middleton, M.D.

  • Family Medicine Physician
  • Westminster, MD
National Provider Identifier
1306829320
Registry record updated May 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D25443 Issued in MD
Practice address
688C Poole Rd
Westminster, MD 21157-6003
Phone
(410) 857-8202
NPI assigned
Nov 23, 2005
Last updated
May 4, 2009By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 4, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X D25443 MD Primary

Addresses

Primary practice location

688C Poole Rd
Westminster, MD 21157-6003

Mailing address

3525 Halter Rd
Westminster, MD 21158-1901
Phone (410) 857-8202

Other identifiers 1

IdentifierTypeStateIssuer
337321500MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040714001569 MD Practitioner - Family Practice 4587640669 Reassigns benefits to 1 organization
Receives reassigned benefits from 2 practitioners
Practice locations: Westminster, MD

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Lifebridge Community Physicians, Inc Current Accepting new patients
John W. Middleton, MD Family Medicine CurrentSince Jan 1, 1990 Accepting new patients
Lifebridge Community Physicians, Inc Family Medicine CurrentSince Apr 25, 2016 Accepting new patients
Lifebridge Community Physicians Inc CurrentSince Apr 25, 2016 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Family Medical Associates,LLC Family Medicine Past Accepting new patients

Locations

410 Malcolm Dr
Ste A
Westminster, MD 21157
Phone (410) 876-1633

688 Poole Rd
Westminster, MD 21157
Phone (410) 857-8202

688 Poole Rd
Ste C
Westminster, MD 21157
Phone (410) 552-4202

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9750/brand/1/csg/1/fhir/r4

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Bridginglife, Inc.Westminster, MD, CCN 211522 Hospice Corporate Director Jul 1, 2017

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 2

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.

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1241395200000",
    "number": "1306829320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3525 HALTER RD",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211581901",
            "telephone_number": "410-857-8202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "688C POOLE RD",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211576003",
            "telephone_number": "410-857-8202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIDDLETON",
        "first_name": "JOHN",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-23",
        "last_updated": "2009-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D25443",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "337321500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, MD

Sources for this page

Verify at the official NPI Registry.