Individual provider Active NPI

Nicholas Lee Ogburn, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Salisbury, MD
National Provider Identifier
1326012691
Registry record updated Apr 24, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X
License
D34593 Issued in MD
Practice address
100 E Carroll St
3Rd Floor, West Tower
Salisbury, MD 21801-5422
Phone
(410) 546-1353
Fax
(410) 543-8360
NPI assigned
Feb 14, 2006
Last updated
Apr 24, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X D34593 MD
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician 208G00000X D34593 MD Primary

Addresses

Primary practice location

100 E Carroll St
3Rd Floor, West Tower
Salisbury, MD 21801-5422

Mailing address

100 E Carroll St
3Rd Floor, West Tower
Salisbury, MD 21801-5422
Phone (410) 546-1353

Other identifiers 1

IdentifierTypeStateIssuer
435991700MedicaidMD

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

LicenseStateTypeSpecialty
D34593MDMDThoracic Surgery (Cardiothoracic Vascular Surgery) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CV Surgical Associates PA Vascular Surgery CurrentSince Jan 1, 2009 Accepting new patients
Tidalhealth Specialty Care, LLC Past Accepting new patients

Locations

100 E Carroll St
Salisbury, MD 21801
Phone (410) 543-7100

100 E Carroll St
Fl 3
Salisbury, MD 21801
Phone (301) 546-1353

Organizations & group practices 2

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": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398297600000",
    "number": "1326012691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E CARROLL ST",
            "address_2": "3RD FLOOR, WEST TOWER",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218015422",
            "telephone_number": "410-546-1353",
            "fax_number": "410-543-8360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E CARROLL ST",
            "address_2": "3RD FLOOR, WEST TOWER",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218015422",
            "telephone_number": "410-546-1353",
            "fax_number": "410-543-8360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGBURN",
        "first_name": "NICHOLAS",
        "middle_name": "LEE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2014-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MD",
            "license": "D34593",
            "primary": false
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "MD",
            "license": "D34593",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "435991700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.