Organization Active NPI

Family Medicine of Gaithersburg

  • Family Medicine Physician
  • Gaithersburg, MD
National Provider Identifier
1437317955
Registry record updated May 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FAMILY MEDICINE OF GAITHERSBURG
Practice address
981 Russell Ave
Gaithersburg, MD 20879-6219
Phone
(301) 740-8732
NPI assigned
May 30, 2008
Last updated
May 30, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2008

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

Authorized official

Name
Caryl Matthew
Title
Dir of Operations
Phone
(301) 216-2065

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

981 Russell Ave
Gaithersburg, MD 20879-6219

Mailing address

981 Russell Ave
Gaithersburg, MD 20879-6219

Other identifiers 1

IdentifierTypeStateIssuer
002760000MedicaidMD

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, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1212105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212105600000",
    "number": "1437317955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "981 RUSSELL AVE",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208796219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "981 RUSSELL AVE",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208796219",
            "telephone_number": "301-740-8732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICINE OF GAITHERSBURG",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-30",
        "last_updated": "2008-05-30",
        "status": "A",
        "authorized_official_last_name": "MATTHEW",
        "authorized_official_first_name": "CARYL",
        "authorized_official_title_or_position": "DIR OF OPERATIONS",
        "authorized_official_telephone_number": "301-216-2065"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002760000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaithersburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2008; 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.