NPIMap

Organization Active NPI

Mid Atlantic Medicine LLC

  • Urgent Care Clinic/Center
  • Washington, DC
National Provider Identifier
1508459199
Registry record updated Feb 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
MID ATLANTIC MEDICINE LLC
Practice address
2228 Martin Luther King Jr Ave SE
Washington, DC 20020-5700
Phone
(202) 964-4727
Fax
(202) 902-2238
NPI assigned
Feb 16, 2021
Last updated
Feb 23, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2023

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

Authorized official

Name
Todd Evans
Title
VP Ipm
Phone
(610) 768-3300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

2228 Martin Luther King Jr Ave SE
Washington, DC 20020-5700

Mailing address

PO Box 746004
Atlanta, GA 30374-6004
Phone (484) 250-8475

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221021002558 DC Part B Supplier - Clinic/Group Practice 6204202864 Receives reassigned benefits from 17 practitioners
Practice locations: Washington, DC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1613433600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677110400000",
    "number": "1508459199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746004",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303746004",
            "telephone_number": "484-250-8475",
            "fax_number": "484-913-7587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2228 MARTIN LUTHER KING JR AVE SE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200205700",
            "telephone_number": "202-964-4727",
            "fax_number": "202-902-2238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID ATLANTIC MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-16",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A",
        "authorized_official_last_name": "EVANS",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "VP IPM",
        "authorized_official_telephone_number": "610-768-3300"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2023; 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.