NPIMap

Organization Active NPI

Security Ambulatory Surgi Center, LLC

  • Podiatric Clinic/Center
  • Catonsville, MD
National Provider Identifier
1396775201
Registry record updated Aug 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Podiatric Clinic/CenterTaxonomy code 261QP1100X
License
A1357 Issued in MD
Legal business name
SECURITY AMBULATORY SURGI CENTER, LLC
Practice address
2 E Rolling Crossroads
Suite 55
Catonsville, MD 21228-6212
Phone
(410) 455-9660
Fax
(410) 455-9665
NPI assigned
Jul 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2018

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

Authorized official

Name
John Galloway Roth Jr., D.P.M.
Title
President
Phone
(410) 455-9660

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X A1357 MD
Podiatric Clinic/Center 261QP1100X A1357 MD Primary

Addresses

Primary practice location

2 E Rolling Crossroads
Suite 55
Catonsville, MD 21228-6212

Mailing address

2 E Rolling Crossroads
Suite 55
Catonsville, MD 21228-6212
Phone (410) 455-9660

Other identifiers 3

IdentifierTypeStateIssuer
024DOtherMDBLUECROSS BLUESHIELD MD
RI5OtherMDCAREFIRST BLUECHOICE
3416026OtherMDAETNA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534464000000",
    "number": "1396775201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 E ROLLING CROSSROADS",
            "address_2": "SUITE 55",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212286212",
            "telephone_number": "410-455-9660",
            "fax_number": "410-455-9665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 E ROLLING CROSSROADS",
            "address_2": "SUITE 55",
            "city": "CATONSVILLE",
            "state": "MD",
            "postal_code": "212286212",
            "telephone_number": "410-455-9660",
            "fax_number": "410-455-9665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SECURITY AMBULATORY SURGI CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2018-08-17",
        "status": "A",
        "authorized_official_last_name": "ROTH",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "GALLOWAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-455-9660",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MD",
            "license": "A1357",
            "primary": false
        },
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": "MD",
            "license": "A1357",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD MD",
            "identifier": "024D",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BLUECHOICE",
            "identifier": "RI5",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3416026",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Catonsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; 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.