Endoscopic Surgical Centre of Maryland-North LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

A1368 Issued in MD

Legal business name

ENDOSCOPIC SURGICAL CENTRE OF MARYLAND-NORTH LLC

Doing business as

Endoscopic Surgical Centre of Maryland North

Practice address

15005 Shady Grove Rd
Suite 300
Rockville, MD 20850-6340

Phone

(310) 762-1280

Fax

(301) 762-5678

NPI assigned

Oct 2, 2006

Last updated

Apr 20, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Christopher A Holden

Title

Chief Manager of LLC

Phone

(615) 665-1283

Specialties & licenses 1

Addresses

Other identifiers 6

Other names 1

• Endoscopic Surgical Centre of Maryland North Doing business as

Locations

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1528151586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15005 SHADY GROVE RD",
            "address_2": "SUITE 300",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208506340",
            "telephone_number": "310-762-1280",
            "fax_number": "301-762-5678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15005 SHADY GROVE RD",
            "address_2": "SUITE 300",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208506340",
            "telephone_number": "310-762-1280",
            "fax_number": "301-762-5678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENDOSCOPIC SURGICAL CENTRE OF MARYLAND-NORTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "HOLDEN",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF MANAGER OF LLC",
        "authorized_official_telephone_number": "615-665-1283",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MD",
            "license": "A1368",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF DC",
            "identifier": "PY6",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPPO",
            "identifier": "522576",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER INSURANCE",
            "identifier": "237001",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITEDHEALTHCARE PROVIDER",
            "identifier": "6800326",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI PROVIDER NUMBER",
            "identifier": "236707",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF MARYLAND",
            "identifier": "61779101",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Endoscopic Surgical Centre of Maryland North",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ambulatory Surgical Clinic/Center in Rockville, MD
• Providers in Rockville, MD by specialty
• Ambulatory Surgical Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.