Jack J Van Geffen, M.D.

Primary specialty

Nuclear Radiology PhysicianTaxonomy code 2085N0904X

License

D0019967 Issued in MD

Practice address

2002 Medical Pkwy
Suite 235
Annapolis, MD 21401-3046

Phone

(410) 266-2770

Fax

(410) 841-6251

NPI assigned

Aug 11, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 10

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Shipley'S Imaging, LLC

  • Diagnostic Radiology Physician
  • Millersville, MD
  • NPI 1861476343
  NPD (past)

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289865600000",
    "number": "1487656245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2002 MEDICAL PKWY",
            "address_2": "SUITE 235",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013046",
            "telephone_number": "410-266-2770",
            "fax_number": "410-841-6251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 MEDICAL PKWY",
            "address_2": "SUITE 235",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013046",
            "telephone_number": "410-266-2770",
            "fax_number": "410-841-6251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN GEFFEN",
        "first_name": "JACK",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-11",
        "last_updated": "2010-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0904X",
            "taxonomy_group": "",
            "desc": "Radiology, Nuclear Radiology",
            "state": "MD",
            "license": "D0019967",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "10690008",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE SHIPLEYS IMAGING",
            "identifier": "1487656245",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRAVELERS RR MEDICARE",
            "identifier": "300031317",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AAD PG COUNTY",
            "identifier": "A14",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN DC BOWIE",
            "identifier": "414894ZED1",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "8317071",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "155951600",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO/POS",
            "identifier": "2622593",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AAD SHIPLEYS",
            "identifier": "494M",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AAD AA COUNTY",
            "identifier": "JG95",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jonette Lee Vagts, RPH
• Heather Vail
• Jason Valadao, M.D.
• Stephen Anthony Valenti, M.D.
• Jennifer Masako Van Dyne
• Ross J Vanantwerp, D.O., M.P.H.
• Joyce Sarah Vanblunk, RN
• Julia A Vanhassent, PA-C
• Edgar Myoung Vanhorne, MD
• John Milton Vanik, DDS

• Nuclear Radiology Physician in Annapolis, MD
• Providers in Annapolis, MD by specialty
• Nuclear Radiology Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2010; 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.