Active NPI
Lester Byron Horrell, M.D.
- Specialist
- Elkton, MD
National Provider Identifier
1376535112
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- D0056952
- Practice address
- 703 N. Bridge St.
Suite 104
Elkton, MD 21921 - Phone
- (410) 398-5930
- Fax
- (410) 398-0165
- NPI assigned
- Aug 18, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | D0056952 | MD | Primary |
Addresses
Primary practice location
703 N. Bridge St.
Suite 104
Elkton, MD 21921
Mailing address
703 N. Bridge St
Suite 104
Elkton, MD 21921
Phone (410) 398-5930
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 007400400 | Medicaid | MD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0056952 | MD | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Premiere Childrens Physicans, PA | Specialist | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/AGJFCD/Endpoint/AGJFCD
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Specialist
- Elkton, MD
- NPI 1235461039
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1124323200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1286150400000",
"number": "1376535112",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "703 N. BRIDGE ST",
"address_2": "SUITE 104",
"city": "ELKTON",
"state": "MD",
"postal_code": "21921",
"telephone_number": "410-398-5930",
"fax_number": "410-398-0165"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "703 N. BRIDGE ST.",
"address_2": "SUITE 104",
"city": "ELKTON",
"state": "MD",
"postal_code": "21921",
"telephone_number": "410-398-5930",
"fax_number": "410-398-0165"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HORRELL",
"first_name": "LESTER",
"middle_name": "BYRON",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-08-18",
"last_updated": "2010-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "MD",
"license": "D0056952",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "007400400",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Elkton, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.