Apple Ridge Family Medicine

Organization Active NPI Family Medicine Physician · Thurmont, MD

NPI 1366497372 · NPPES record last updated Jan 29, 2024

Key facts

NPI
1366497372
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
APPLE RIDGE FAMILY MEDICINE
Practice address
20 Frederick Rd
Thurmont, MD 21788-1809
Phone
(301) 979-9636
Fax
(717) 338-9070
NPI assigned
May 24, 2006
Organization subpart
No

Authorized official

Name
Dr. Talbot Smith, M.D.
Title
President
Phone
(301) 979-9636

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Laboratory certificates & supplier records

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
39D1046312Evergreen Adult Medicine
20 Frederick Rd, Thurmont, MD 21788
Certificate of waiverJun 8, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in PA, MD

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20050909000283 PA Part B Supplier - Clinic/Group Practice 9537191606 Receives reassigned benefits from 3 practitioners
Practice locations: Gettysburg, PA
O20240125002684 MD Part B Supplier - Clinic/Group Practice 9537191606 Receives reassigned benefits from 2 practitioners
Practice locations: Thurmont, MD

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X Yes

Addresses

Primary practice location

20 Frederick Rd
Thurmont, MD 21788-1809

Mailing address

20 Frederick Rd
Thurmont, MD 21788-1809
Phone (301) 979-9636

Other names

  • Evergreen Adult Medicine Doing business as

Other providers in Thurmont, MD

All providers in Thurmont, MD · Family Medicine Physician in Maryland

Sources for this page

Verify at the official NPI Registry.