NPIMap

Organization Active NPI

Statcare Group IV, PC

Doing business as ChoiceOne Urgent Care IV

  • Urgent Care Clinic/Center
  • Severna Park, MD
National Provider Identifier
1548711872
Registry record updated Dec 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
License
H0062737 Issued in MD
Legal business name
STATCARE GROUP IV, PC
Doing business as
ChoiceOne Urgent Care IV
Practice address
500 Ritchie Hwy
Suite B
Severna Park, MD 21146-2954
Phone
(410) 296-7190
Fax
(410) 296-0344
NPI assigned
Oct 21, 2016
Last updated
Dec 27, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2018

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

Authorized official

Name
Dr. Scott Theodore Burger, D.O.
Title
Chief Medical Officer
Phone
(410) 296-7190

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Care Clinic/Center 261QE0002X HOO62737 MD
Urgent Care Clinic/Center 261QU0200X H0062737 MD Primary

Addresses

Primary practice location

500 Ritchie Hwy
Suite B
Severna Park, MD 21146-2954

Mailing address

1400 Front Ave
Suite 300
Lutherville, MD 21093-5300
Phone (410) 296-7190

Other identifiers 1

IdentifierTypeStateIssuer
HOO62737OtherMDMEDICAL LICENSE

Other names 1

  • ChoiceOne Urgent Care IV Doing business as

National Provider Directory

National Provider Directory

Locations

500 Ritchie Hwy
Ste B
Severna Park, MD 21146
Phone (410) 793-1940

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1477008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545868800000",
    "number": "1548711872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 FRONT AVE",
            "address_2": "SUITE 300",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210935300",
            "telephone_number": "410-296-7190",
            "fax_number": "443-991-7768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 RITCHIE HWY",
            "address_2": "SUITE B",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211462954",
            "telephone_number": "410-296-7190",
            "fax_number": "410-296-0344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATCARE GROUP IV, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-21",
        "last_updated": "2018-12-27",
        "status": "A",
        "authorized_official_last_name": "BURGER",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "THEODORE",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "410-296-7190",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": "MD",
            "license": "HOO62737",
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "MD",
            "license": "H0062737",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "HOO62737",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ChoiceOne Urgent Care IV",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ChoiceOne Urgent Care IV",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Severna Park, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2018; 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.