NPIMap

Organization Active NPI

Leisure World of Maryland, Corp.

Doing business as Leisure World Medical Center

  • Geriatric Medicine (Internal Medicine) Physician
  • Silver Spring, MD
National Provider Identifier
1326076894
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
LEISURE WORLD OF MARYLAND, CORP.
Doing business as
Leisure World Medical Center
Practice address
3305 N Leisure World Blvd
Silver Spring, MD 20906-1367
Phone
(301) 598-1590
Fax
(301) 598-1569
NPI assigned
Jun 30, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Virginia BronaughNPI 1447220181
Title
Administrator
Phone
(301) 598-1550

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0300X Primary

Addresses

Primary practice location

3305 N Leisure World Blvd
Silver Spring, MD 20906-1367

Mailing address

3305 N Leisure World Blvd
Silver Spring, MD 20906-1367
Phone (301) 598-1590

Other names 1

  • Leisure World Medical Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1326076894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3305 N LEISURE WORLD BLVD",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209061367",
            "telephone_number": "301-598-1590",
            "fax_number": "301-598-1569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3305 N LEISURE WORLD BLVD",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209061367",
            "telephone_number": "301-598-1590",
            "fax_number": "301-598-1569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEISURE WORLD OF MARYLAND, CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BRONAUGH",
        "authorized_official_first_name": "VIRGINIA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "301-598-1550"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Leisure World Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Silver Spring, MD

Sources for this page

  • 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.