NPIMap

Organization Active NPI

Laurel Lakes Foot and Ankle ASC

  • Ambulatory Surgical Clinic/Center
  • Laurel, MD
National Provider Identifier
1457520983
Registry record updated Feb 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
00560 Issued in MD
Legal business name
LAUREL LAKES FOOT AND ANKLE ASC
Practice address
13950 Baltimore Ave
Laurel, MD 20707-5000
Phone
(301) 317-6800
Fax
(301) 317-4183
NPI assigned
Feb 28, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2008

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

Authorized official

Name
Dr. Scott W Nutter, DPMNPI 1972782142
Title
President
Phone
(301) 317-6800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 00560 MD Primary

Addresses

Primary practice location

13950 Baltimore Ave
Laurel, MD 20707-5000

Mailing address

13950 Baltimore Ave
Laurel, MD 20707-5000
Phone (301) 317-6800

Other identifiers 9

IdentifierTypeStateIssuer
91242OtherAETNA
A050OtherAMERIGROUP
496067OtherNCPPO
7998686000MedicaidMD
0001OtherDCBLUE SHIELD OF DC
998EOtherTRICARE
252513OtherVABLUE SHIELD OF VA
91242OtherMDMAMSI
41866201OtherMDBLUE SHIELD OF MD

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": "1204156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204156800000",
    "number": "1457520983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13950 BALTIMORE AVE",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075000",
            "telephone_number": "301-317-6800",
            "fax_number": "301-317-4183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13950 BALTIMORE AVE",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075000",
            "telephone_number": "301-317-6800",
            "fax_number": "301-317-4183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAUREL LAKES FOOT AND ANKLE ASC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-28",
        "last_updated": "2008-02-28",
        "status": "A",
        "authorized_official_last_name": "NUTTER",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-317-6800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MD",
            "license": "00560",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "91242",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "A050",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPPO",
            "identifier": "496067",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7998686000",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF DC",
            "identifier": "0001",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "998E",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF VA",
            "identifier": "252513",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "91242",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF MD",
            "identifier": "41866201",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 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.