NPIMap

Organization Active NPI

4M Emergency Systems Andover LLC

  • Emergency Medicine Physician
  • Andover, OH
National Provider Identifier
1346292364
Registry record updated Jul 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
4M EMERGENCY SYSTEMS ANDOVER LLC
Practice address
476 S Main St
Andover, OH 44003-9602
Phone
(330) 841-4000
Fax
(330) 656-5901
NPI assigned
May 17, 2006
Last updated
Jul 21, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2020

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

Authorized official

Name
Amy Charley
Title
Chief Legal Officer
Phone
(240) 686-2300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X Primary

Addresses

Primary practice location

476 S Main St
Andover, OH 44003-9602

Mailing address

12420 Milestone Center Dr Ste 200
Germantown, MD 20876-7111
Phone (240) 686-2300

Other identifiers 1

IdentifierTypeStateIssuer
0000000385522OtherOHANTHEM

Other names 1

  • Alteon Health Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595289600000",
    "number": "1346292364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12420 MILESTONE CENTER DR STE 200",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208767111",
            "telephone_number": "240-686-2300",
            "fax_number": "240-686-2329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "476 S MAIN ST",
            "city": "ANDOVER",
            "state": "OH",
            "postal_code": "440039602",
            "telephone_number": "330-841-4000",
            "fax_number": "330-656-5901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "4M EMERGENCY SYSTEMS ANDOVER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2020-07-21",
        "certification_date": "2020-07-21",
        "status": "A",
        "authorized_official_last_name": "CHARLEY",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "CHIEF LEGAL OFFICER",
        "authorized_official_telephone_number": "240-686-2300"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "0000000385522",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Alteon Health",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Andover, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.