Calverthealth Medical Center, Inc.

Primary specialty

Mobile Radiology Clinic/CenterTaxonomy code 261QR0208X

License

04-001 Issued in MD

Legal business name

CALVERTHEALTH MEDICAL CENTER, INC.

Practice address

85 Hospital Rd
Prince Frederick, MD 20678-4018

Phone

(410) 535-8320

Fax

(410) 535-8109

NPI assigned

Oct 9, 2013

Organization subpart

Yes

Parent organization

CALVERT HEALTH SYSTEM, INCAs reported in NPPES

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

Authorized official

Name

Dean Teague

Title

President/Ceo

Phone

(410) 535-8239

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• CalvertHealth Imaging Services at CCNC Doing business as

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

{
    "created_epoch": "1381276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1516838400000",
    "number": "1407283302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL RD",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206784017",
            "telephone_number": "410-414-4791",
            "fax_number": "410-414-4558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 HOSPITAL RD",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206784018",
            "telephone_number": "410-535-8320",
            "fax_number": "410-535-8109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALVERTHEALTH MEDICAL CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CALVERT HEALTH SYSTEM, INC",
        "enumeration_date": "2013-10-09",
        "last_updated": "2018-01-25",
        "status": "A",
        "authorized_official_last_name": "TEAGUE",
        "authorized_official_first_name": "DEAN",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "410-535-8239"
    },
    "taxonomies": [
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": "MD",
            "license": "04-001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "422051000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CalvertHealth Imaging Services at CCNC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Calvert OBGYN Associates of Southern Maryland, LLC
• Calvert Pathology LLC
• Calvert Physical Therapy and Sports Fitness Center
• Calvert Physical Therapy and Sports Fitness Ctr.
• Calvert Substance Abuse Services
• Calverthealth Medical Center, Inc.
• Calverthealth Medical Center, Inc.
• Calverthealth Medical Center, Inc.
• Calverthealth Medical Group
• Calverthealth Medical Group, LLC

• All providers in Prince Frederick, MD
• Mobile Radiology Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.