Organization Active NPI

Garrett Medical Group, PA

  • Family Medicine Physician
  • Oakland, MD
National Provider Identifier
1487751608
Registry record updated Oct 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
GARRETT MEDICAL GROUP, PA
Practice address
311 N 4TH St
Oakland, MD 21550-1395
Phone
(301) 334-8171
Fax
(301) 334-1807
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2007

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

Authorized official

Name
Mr. Robert C Boone
Title
Administrator
Phone
(301) 334-8171

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

311 N 4TH St
Oakland, MD 21550-1395

Mailing address

311 N 4TH St
Oakland, MD 21550-1395
Phone (301) 334-8171

Other identifiers 1

IdentifierTypeStateIssuer
0006936000MedicaidWV

National Provider Directory

National Provider Directory

Locations

39 Cortland Acres Ln
Thomas, WV 26292
Phone (304) 463-4181

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": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192406400000",
    "number": "1487751608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 N 4TH ST",
            "city": "OAKLAND",
            "state": "MD",
            "postal_code": "215501395",
            "telephone_number": "301-334-8171",
            "fax_number": "301-334-1807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 N 4TH ST",
            "city": "OAKLAND",
            "state": "MD",
            "postal_code": "215501395",
            "telephone_number": "301-334-8171",
            "fax_number": "301-334-1807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARRETT MEDICAL GROUP, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2007-10-15",
        "status": "A",
        "authorized_official_last_name": "BOONE",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "301-334-8171",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0006936000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakland, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2007; 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.