NPIMap

Organization Active NPI

Specialty Physicians of Garrett County, LLC

  • Nurse Practitioner
  • Friendsville, MD
National Provider Identifier
1508678848
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
SPECIALTY PHYSICIANS OF GARRETT COUNTY, LLC
Practice address
250 Maple St
Friendsville, MD 21531-2122
Phone
(301) 746-4160
Fax
(301) 746-4162
NPI assigned
Jan 23, 2025
Last updated
Jan 23, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
SPECIALTY PHYSICIANS OF GARRETT COUNTY, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Authorized official

Name
Lori Dixon
Title
Director, Finance
Phone
(301) 533-4251

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X Primary

Addresses

Primary practice location

250 Maple St
Friendsville, MD 21531-2122

Mailing address

PO Box 1647
Morgantown, WV 26507-1647

National Provider Directory

National Provider Directory
Tax ID family
Specialty Physicians of Garrett County LLC22 organizations share this tax ID, including this one
Part of
Specialty Physicians of Garrett County LLC

Other organizations with this tax ID 21

Organizations that report the same tax identification number in the National Provider Directory.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1737590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737590400000",
    "number": "1508678848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1647",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265071647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 MAPLE ST",
            "city": "FRIENDSVILLE",
            "state": "MD",
            "postal_code": "215312122",
            "telephone_number": "301-746-4160",
            "fax_number": "301-746-4162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY PHYSICIANS OF GARRETT COUNTY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPECIALTY PHYSICIANS OF GARRETT COUNTY, LLC",
        "enumeration_date": "2025-01-23",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A",
        "authorized_official_last_name": "DIXON",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "DIRECTOR, FINANCE",
        "authorized_official_telephone_number": "301-533-4251"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Friendsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; 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.