NPIMap

Organization Active NPI

Mountain View Primary Care Inc

  • Primary Care Clinic/Center
  • Cumberland, MD
National Provider Identifier
1508166752
Registry record updated Feb 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
R087737 Issued in MD
Legal business name
MOUNTAIN VIEW PRIMARY CARE INC
Practice address
1602 Ford Ave
Cumberland, MD 21502-4612
Phone
(301) 759-4544
Fax
(301) 723-4446
NPI assigned
Oct 21, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2016

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

Authorized official

Name
Thomas Alan Bostaph, CRNPNPI 1093769127
Title
President / Owner
Phone
(240) 522-8250

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X R087737 MD Primary

Addresses

Primary practice location

1602 Ford Ave
Cumberland, MD 21502-4612

Mailing address

1602 Ford Ave
Cumberland, MD 21502-4612
Phone (301) 759-4544

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110311000765 MD Part B Supplier - Clinic/Group Practice 3476735465 Receives reassigned benefits from 4 practitioners
Practice locations: Cumberland, MD

National Provider Directory

National Provider Directory

Locations

1602 Ford Ave
Cumberland, MD 21502
Phone (301) 759-4544

Practitioners & affiliated clinicians

Practitioners 4

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": "1287619200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455840000000",
    "number": "1508166752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1602 FORD AVE",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215024612",
            "telephone_number": "301-759-4544",
            "fax_number": "301-723-4446"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1602 FORD AVE",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215024612",
            "telephone_number": "301-759-4544",
            "fax_number": "301-723-4446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN VIEW PRIMARY CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-21",
        "last_updated": "2016-02-19",
        "status": "A",
        "authorized_official_last_name": "BOSTAPH",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT / OWNER",
        "authorized_official_telephone_number": "240-522-8250",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MD",
            "license": "R087737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumberland, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2016; 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.