NPIMap

Organization Active NPI

Elkton General Surgery, LLC

  • Surgery Physician
  • Elkton, MD
National Provider Identifier
1548246556
Registry record updated Dec 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
ELKTON GENERAL SURGERY, LLC
Practice address
111 West High St.
Suite 207
Elkton, MD 21921
Phone
(410) 398-3950
Fax
(410) 398-8661
NPI assigned
Dec 21, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2014

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

Authorized official

Name
Elizabeth Lowe, M.D.
Title
Owner
Phone
(410) 398-3950

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X MD Primary

Addresses

Primary practice location

111 West High St.
Suite 207
Elkton, MD 21921

Mailing address

210 Chesapeake Blvd.
Elkton, MD 21921-6395
Phone (410) 398-3868

Other identifiers 1

IdentifierTypeStateIssuer
406465800MedicaidMD

Other names 1

  • Tri-State Surgical Assoc LLC Former legal business name

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1135123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418688000000",
    "number": "1548246556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 CHESAPEAKE BLVD.",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219216395",
            "telephone_number": "410-398-3868",
            "fax_number": "410-398-8661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 WEST HIGH ST.",
            "address_2": "SUITE 207",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "21921",
            "telephone_number": "410-398-3950",
            "fax_number": "410-398-8661"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELKTON GENERAL SURGERY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-21",
        "last_updated": "2014-12-16",
        "status": "A",
        "authorized_official_last_name": "LOWE",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-398-3950",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "406465800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tri-State Surgical Assoc LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Elkton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2014; 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.