NPIMap

Organization Active NPI

Advanced Pain Surgery Center LLC

  • Ambulatory Surgical Clinic/Center
  • Waldorf, MD
National Provider Identifier
1447580394
Registry record updated Dec 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
ADVANCED PAIN SURGERY CENTER LLC
Practice address
12070 Old Line Ctr Ste 205
Waldorf, MD 20602-2567
Phone
(240) 629-3920
Fax
(240) 629-3921
NPI assigned
Dec 28, 2009
Last updated
Dec 10, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2017

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

Authorized official

Name
Khalid a Kahloon
Title
Ceo
Phone
(502) 261-7200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X Primary

Addresses

Primary practice location

12070 Old Line Ctr Ste 205
Waldorf, MD 20602-2567

Mailing address

1050 Key Pkwy Ste 202
Frederick, MD 21702-4551
Phone (240) 629-3990

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1261958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512864000000",
    "number": "1447580394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 KEY PKWY STE 202",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024551",
            "telephone_number": "240-629-3990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12070 OLD LINE CTR STE 205",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206022567",
            "telephone_number": "240-629-3920",
            "fax_number": "240-629-3921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED PAIN SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-28",
        "last_updated": "2017-12-10",
        "status": "A",
        "authorized_official_last_name": "KAHLOON",
        "authorized_official_first_name": "KHALID A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "502-261-7200"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2017; 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.