Rediclinic of MD, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

REDICLINIC OF MD, LLC

Practice address

8601 Baltimore National Pike
Ellicott City, MD 21043-4176

Phone

(713) 335-1742

Fax

(713) 358-4881

NPI assigned

May 4, 2015

Last updated

May 4, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Danielle Barrera

Title

Chief Operating Officer

Phone

(713) 580-9489

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1430697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430697600000",
    "number": "1356728984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 GREENWAY PLZ",
            "address_2": "STE. 2950",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770460905",
            "telephone_number": "713-335-1754",
            "fax_number": "713-358-4870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8601 BALTIMORE NATIONAL PIKE",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210434176",
            "telephone_number": "713-335-1742",
            "fax_number": "713-358-4881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDICLINIC OF MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-04",
        "last_updated": "2015-05-04",
        "status": "A",
        "authorized_official_last_name": "BARRERA",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "713-580-9489"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Ellicott City, MD
• Providers in Ellicott City, MD by specialty
• Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2015; 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.