NPIMap

Organization Active NPI

Family Medical Center, LLC

  • Specialist
  • Mount Airy, MD
National Provider Identifier
1346430550
Registry record updated Jun 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
FAMILY MEDICAL CENTER, LLC
Practice address
1502 S Main St
Suite 104
Mount Airy, MD 21771-5325
Phone
(410) 489-4927
Fax
(301) 829-7907
NPI assigned
Jul 25, 2007
Last updated
Jun 10, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2011

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

Authorized official

Name
Mrs. Rochelle P Dyer, C.R.N.P.NPI 1487619896
Title
Owner
Phone
(410) 489-4927

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X Primary

Addresses

Primary practice location

1502 S Main St
Suite 104
Mount Airy, MD 21771-5325

Mailing address

1502 S Main St
Suite 104
Mount Airy, MD 21771-5325
Phone (410) 489-4927

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070926000445 MD Part B Supplier - Clinic/Group Practice 3375637069 Receives reassigned benefits from 7 practitioners
Practice locations: Mount Airy, MD; Westminster, MD

National Provider Directory

National Provider Directory

Locations

1502 S Main St
Ste 206
Mount Airy, MD 21771
Phone (301) 829-1887

1502 S Main St
Ste 207
Mount Airy, MD 21771

Practitioners & affiliated clinicians

Practitioners 9

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": "1185321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307664000000",
    "number": "1346430550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1502 S MAIN ST",
            "address_2": "SUITE 104",
            "city": "MOUNT AIRY",
            "state": "MD",
            "postal_code": "217715325",
            "telephone_number": "410-489-4927",
            "fax_number": "301-829-7907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 S MAIN ST",
            "address_2": "SUITE 104",
            "city": "MOUNT AIRY",
            "state": "MD",
            "postal_code": "217715325",
            "telephone_number": "410-489-4927",
            "fax_number": "301-829-7907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-25",
        "last_updated": "2011-06-10",
        "status": "A",
        "authorized_official_last_name": "DYER",
        "authorized_official_first_name": "ROCHELLE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-489-4927",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "C.R.N.P."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Airy, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.