NPIMap

Organization Active NPI

Magnolia Gardens LLC

Doing business as Doctor Community Rehabilitation and Patient Care Center

  • Skilled Nursing Facility
  • Lanham, MD
National Provider Identifier
1518483239
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Skilled Nursing FacilityTaxonomy code 314000000X
Legal business name
MAGNOLIA GARDENS LLC
Doing business as
Doctor Community Rehabilitation and Patient Care Center
Doctors Community Rehabilitation and Patient Care Center
Practice address
6710 Mallery Dr
Lanham, MD 20706-3964
Phone
(301) 552-2000
Fax
(301) 552-2001
NPI assigned
Aug 15, 2017
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
MAGNOLIA JV LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Michael T Berg
Title
Asst Secretary
Phone
(505) 468-4742

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Skilled Nursing Facility 314000000X MD Primary

Addresses

Primary practice location

6710 Mallery Dr
Lanham, MD 20706-3964

Mailing address

6710 Mallery Dr
Lanham, MD 20706-3964
Phone (301) 552-2000

Other names 2

  • DOCTOR COMMUNITY REHABILITATION AND PATIENT CARE CENTER Doing business as
  • DOCTORS COMMUNITY REHABILITATION AND PATIENT CARE CENTER Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D0890113Doctor Community Rehabilition and Patient Care Ctr6710 Mallery Drive, Lanham, MD 20706Certificate of waiverAug 11, 2026

National Provider Directory

National Provider Directory
Tax ID family
Magnolia Gardens LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1502755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1518483239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6710 MALLERY DR",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207063964",
            "telephone_number": "301-552-2000",
            "fax_number": "301-552-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6710 MALLERY DR",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207063964",
            "telephone_number": "301-552-2000",
            "fax_number": "301-552-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA GARDENS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MAGNOLIA JV LLC",
        "enumeration_date": "2017-08-15",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BERG",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "ASST SECRETARY",
        "authorized_official_telephone_number": "505-468-4742"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DOCTOR COMMUNITY REHABILITATION AND PATIENT CARE CENTER",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DOCTORS COMMUNITY REHABILITATION AND PATIENT CARE CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lanham, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.