NPIMap

Organization Active NPI

Northwest Hospital Center, Inc

Doing business as NW Neurology

  • Neurology Physician
  • Randallstown, MD
National Provider Identifier
1467462028
Registry record updated Oct 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
03-004 Issued in MD
Legal business name
NORTHWEST HOSPITAL CENTER, INC
Doing business as
NW Neurology
Practice address
5401 Old Court Rd
Randallstown, MD 21133-5103
Phone
(410) 521-2200
NPI assigned
Aug 8, 2006
Last updated
Oct 20, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2021

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

Authorized official

Name
David McCormick
Title
Avp
Phone
(410) 701-4618

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 03-004 MD
Nurse Practitioner 363L00000X 03-004 MD
Neurology Physician 2084N0400X 03-004 MD Primary

Addresses

Primary practice location

5401 Old Court Rd
Randallstown, MD 21133-5103

Mailing address

5401 Old Court Rd
Attn: Credentialing
Randallstown, MD 21133-5103
Phone (410) 601-5524

Other identifiers 1

IdentifierTypeStateIssuer
CN6601OtherMDR/R MEDICARE GROUP #

Other names 1

  • NW Neurology Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040128000328 MD Part B Supplier - Clinic/Group Practice 6204739352 Receives reassigned benefits from 289 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Randallstown, MD

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Northwest Medical Assoc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634688000000",
    "number": "1467462028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 OLD COURT RD",
            "address_2": "ATTN: CREDENTIALING",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211335103",
            "telephone_number": "410-601-5524",
            "fax_number": "410-601-8946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 OLD COURT RD",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211335103",
            "telephone_number": "410-521-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHWEST HOSPITAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A",
        "authorized_official_last_name": "MCCORMICK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "AVP",
        "authorized_official_telephone_number": "410-701-4618"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": "03-004",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "03-004",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MD",
            "license": "03-004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "R/R MEDICARE GROUP #",
            "identifier": "CN6601",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NW Neurology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "NW Neurology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Randallstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.