NPIMap

Organization Active NPI

Medstar Southern Maryland Physicians, LLC

Doing business as MedStar Southern Maryland Women's Health Center

  • Obstetrics & Gynecology Physician
  • Waldorf, MD
National Provider Identifier
1316340201
Registry record updated Oct 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
MEDSTAR SOUTHERN MARYLAND PHYSICIANS, LLC
Doing business as
MedStar Southern Maryland Women's Health Center
Practice address
11340 Pembrooke SQ
Suite 203
Waldorf, MD 20603-4808
Phone
(301) 843-7737
Fax
(301) 932-7917
NPI assigned
Oct 6, 2014
Last updated
Oct 6, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
MEDSTAR SOUTHERN MARYLAND PHYSICIANS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 6, 2014

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

Authorized official

Name
Jane E. Raymond
Title
V.P. of Physician Services
Phone
(301) 877-4530

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

11340 Pembrooke SQ
Suite 203
Waldorf, MD 20603-4808

Mailing address

11340 Pembrooke SQ
Suite 203
Waldorf, MD 20603-4808
Phone (301) 843-7737

Other names 1

  • MedStar Southern Maryland Women's Health Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Medstar Southern MD Phys13 organizations share this tax ID, including this one
Part of
Medstar Southern MD Phys

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Locations

11340 Pembrooke Sq
Ste 203
Waldorf, MD 20603
Phone (301) 396-2024

NPI Registry JSON

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

{
    "created_epoch": "1412553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412553600000",
    "number": "1316340201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11340 PEMBROOKE SQ",
            "address_2": "SUITE 203",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206034808",
            "telephone_number": "301-843-7737",
            "fax_number": "301-932-7917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11340 PEMBROOKE SQ",
            "address_2": "SUITE 203",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206034808",
            "telephone_number": "301-843-7737",
            "fax_number": "301-932-7917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDSTAR SOUTHERN MARYLAND PHYSICIANS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEDSTAR SOUTHERN MARYLAND PHYSICIANS, LLC",
        "enumeration_date": "2014-10-06",
        "last_updated": "2014-10-06",
        "status": "A",
        "authorized_official_last_name": "RAYMOND",
        "authorized_official_first_name": "JANE",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "V.P. OF PHYSICIAN SERVICES",
        "authorized_official_telephone_number": "301-877-4530"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MedStar Southern Maryland Women's Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2014; 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.