Active NPI
George Brinton Cavanagh, M.D.
- Family Medicine Physician
- Bowie, MD
National Provider Identifier
1477554293
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- D0031602
- Practice address
- 4201 Mitchellville Rd
Suite 102
Bowie, MD 20716-3163 - Phone
- (301) 262-5900
- Fax
- (410) 741-0865
- NPI assigned
- Aug 2, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | D0031602 | MD | Primary |
Addresses
Primary practice location
4201 Mitchellville Rd
Suite 102
Bowie, MD 20716-3163
Mailing address
1111 Benfield Blvd
Suite 200
Millersville, MD 21108-3002
Phone (410) 729-5100
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0472812 | Other | MD | AETNA CAPITATED |
| 4339374 | Other | MD | AETNA FEE FOR SERVICE |
| 235426 | Other | MD | MAMSI SPECIALIST |
| 1370929 | Other | MD | CIGNA PIN |
| 835426 | Other | MD | MAMSI PRIMARY CARE |
| 013140 | Other | MD | JHHC PROVIDER NUMBER |
| 080113969 | Other | MD | RAILROAD MEDICARE |
| 411788-01 | Other | MD | CAREFIRST MD RENDERING |
| P11957 | Other | MD | CAREFIRST MPOS |
| 401571100 | Medicaid | MD | |
| 7605-0027 | Other | MD | CAREFIRST BLUECHOICE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frederick Health Hospital Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Acute Care Hospital
- Frederick, MD
- NPI 1538165527
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1295827200000",
"number": "1477554293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 BENFIELD BLVD",
"address_2": "SUITE 200",
"city": "MILLERSVILLE",
"state": "MD",
"postal_code": "211083002",
"telephone_number": "410-729-5100",
"fax_number": "410-729-5156"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4201 MITCHELLVILLE RD",
"address_2": "SUITE 102",
"city": "BOWIE",
"state": "MD",
"postal_code": "207163163",
"telephone_number": "301-262-5900",
"fax_number": "410-741-0865"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAVANAGH",
"first_name": "GEORGE",
"middle_name": "BRINTON",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-02",
"last_updated": "2011-01-24",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MD",
"license": "D0031602",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA CAPITATED",
"identifier": "0472812",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA FEE FOR SERVICE",
"identifier": "4339374",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI SPECIALIST",
"identifier": "235426",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA PIN",
"identifier": "1370929",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAMSI PRIMARY CARE",
"identifier": "835426",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JHHC PROVIDER NUMBER",
"identifier": "013140",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "080113969",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST MD RENDERING",
"identifier": "411788-01",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST MPOS",
"identifier": "P11957",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "401571100",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST BLUECHOICE",
"identifier": "7605-0027",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Bowie, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.