NPIMap

Organization Active NPI

Luminis Health Medical Group, LLC

  • Obstetrics & Gynecology Physician
  • Annapolis, MD
National Provider Identifier
1497955272
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
LUMINIS HEALTH MEDICAL GROUP, LLC
Practice address
132 Holiday CT
Suite 210
Annapolis, MD 21401-7005
Phone
(410) 266-8663
Fax
(410) 268-6000
NPI assigned
Jul 20, 2007
Organization subpart
Yes
Parent organization
ANNE ARUNDEL PHYSICIAN GROUP LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 24, 2021

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

Authorized official

Name
Mr. Stephen L Clarke
Title
Vice President
Phone
(443) 481-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X Primary

Addresses

Primary practice location

132 Holiday CT
Suite 210
Annapolis, MD 21401-7005

Mailing address

PO Box 64401
Baltimore, MD 21264-4935
Phone (443) 481-6520

Other names 1

  • OBGYN MEDICAL RESOURCES Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050317000146 MD Part B Supplier - Clinic/Group Practice 2860447315 Receives reassigned benefits from 897 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
Anne Arundel Phys Group LLC221 organizations share this tax ID, including this one
Part of
Anne Arundel Phys Group LLC

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1332 Cape St Claire Rd
Annapolis, MD 21409
Phone (443) 481-5618

821 W Benfield Rd
Severna Park, MD 21146
Phone (410) 236-7489

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1184889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621814400000",
    "number": "1497955272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64401",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644935",
            "telephone_number": "443-481-6520",
            "fax_number": "443-481-6515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 HOLIDAY CT",
            "address_2": "SUITE 210",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017005",
            "telephone_number": "410-266-8663",
            "fax_number": "410-268-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUMINIS HEALTH MEDICAL GROUP, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ANNE ARUNDEL PHYSICIAN GROUP LLC",
        "enumeration_date": "2007-07-20",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A",
        "authorized_official_last_name": "CLARKE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "443-481-1000",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "OBGYN MEDICAL RESOURCES",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "OBGYN MEDICAL RESOURCES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.