NPIMap

Organization Active NPI

Specialty Physicians of Garrett County, LLC

  • Surgery Physician
  • Oakland, MD
National Provider Identifier
1336951680
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
SPECIALTY PHYSICIANS OF GARRETT COUNTY, LLC
Practice address
255 N 4TH St Ste 2
Oakland, MD 21550-1340
Phone
(301) 334-8282
Fax
(301) 334-8468
NPI assigned
Jan 23, 2025
Last updated
Jan 23, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
SPECIALTY PHYSICIANS OF GARRETT COUNTY, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Authorized official

Name
Lori Dixon
Title
Director, Finance
Phone
(301) 533-4251

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X Primary

Addresses

Primary practice location

255 N 4TH St Ste 2
Oakland, MD 21550-1340

Mailing address

PO Box 1647
Morgantown, WV 26507-1647

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D0939608Specialty Physicians of Garrett County255 North Fourth Street Suite 2, Oakland, MD 21550Certificate of waiverJan 27, 2028

National Provider Directory

National Provider Directory
Tax ID family
Spec Phys of Garrett Co LLC22 organizations share this tax ID, including this one
Part of
Spec Phys of Garrett Co LLC

Other organizations with this tax ID 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1737590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737590400000",
    "number": "1336951680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1647",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265071647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 N 4TH ST STE 2",
            "city": "OAKLAND",
            "state": "MD",
            "postal_code": "215501340",
            "telephone_number": "301-334-8282",
            "fax_number": "301-334-8468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY PHYSICIANS OF GARRETT COUNTY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPECIALTY PHYSICIANS OF GARRETT COUNTY, LLC",
        "enumeration_date": "2025-01-23",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A",
        "authorized_official_last_name": "DIXON",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "DIRECTOR, FINANCE",
        "authorized_official_telephone_number": "301-533-4251"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.