Intermed Ipa Cto, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

INTERMED IPA CTO, LLC

Practice address

9106 Philadelphia Rd Ste 214
Baltimore, MD 21237-4333

Phone

(410) 780-1980

NPI assigned

Nov 7, 2019

Organization subpart

No

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

Authorized official

Name

Van Lomis, MD

Title

Vice President

Phone

(410) 371-4492

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1573084800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573084800000",
    "number": "1487299020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9106 PHILADELPHIA RD STE 214",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212374333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9106 PHILADELPHIA RD STE 214",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212374333",
            "telephone_number": "410-780-1980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERMED IPA CTO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-07",
        "last_updated": "2019-11-07",
        "status": "A",
        "authorized_official_last_name": "LOMIS",
        "authorized_official_first_name": "VAN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "410-371-4492",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Internal Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2019; 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.