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
-
Talbot Lee Smith, MD
-
Meagan Lyn Weaver, PA-C
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 39D1046312 | Evergreen Adult Medicine | Certificate of waiver | Jun 8, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in PA, MD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
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
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All providers in Thurmont, MD · Family Medicine Physician in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 29, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.