NPIMap

Organization Active NPI

University of Maryland Community Medical Group, Inc.

  • Family Medicine Physician
  • Glen Burnie, MD
National Provider Identifier
1396536140
Registry record updated May 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
UNIVERSITY OF MARYLAND COMMUNITY MEDICAL GROUP, INC.
Practice address
255 Hospital Dr Ste 108
Glen Burnie, MD 21061-5801
Phone
(410) 757-4675
NPI assigned
May 13, 2025
Last updated
May 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2025

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

Authorized official

Name
Paul Stephen Nicholson
Title
Senior Vice President
Phone
(410) 337-1602

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary
Pediatrics Physician 208000000X

Addresses

Primary practice location

255 Hospital Dr Ste 108
Glen Burnie, MD 21061-5801

Mailing address

900 Elkridge Landing Rd FL 2
Linthicum, MD 21090-2924
Phone (443) 462-5010

National Provider Directory

National Provider Directory
Tax ID family
University of Maryland Community Medical Group Inc176 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1747094400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747094400000",
    "number": "1396536140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 ELKRIDGE LANDING RD FL 2",
            "city": "LINTHICUM",
            "state": "MD",
            "postal_code": "210902924",
            "telephone_number": "443-462-5010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 HOSPITAL DR STE 108",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615801",
            "telephone_number": "410-757-4675"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF MARYLAND COMMUNITY MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-13",
        "last_updated": "2025-05-13",
        "certification_date": "2025-05-13",
        "status": "A",
        "authorized_official_last_name": "NICHOLSON",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "STEPHEN",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
        "authorized_official_telephone_number": "410-337-1602"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2025; 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.