NPIMap

Organization Active NPI

Preventive Care Network

  • Internal Medicine Physician
  • Grasonville, MD
National Provider Identifier
1548822232
Registry record updated Jul 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PREVENTIVE CARE NETWORK
Practice address
204 Medical Center Dr
Grasonville, MD 21638-1400
Phone
(410) 827-8117
NPI assigned
Jul 2, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2019

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

Authorized official

Name
Victor Herry, M.D.NPI 1073642625
Title
Ceo
Phone
(301) 868-7333

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

204 Medical Center Dr
Grasonville, MD 21638-1400

Mailing address

204 Medical Center Dr
Grasonville, MD 21638-1400
Phone (410) 827-8117

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CCIJBA

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1562025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562025600000",
    "number": "1548822232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 MEDICAL CENTER DR",
            "city": "GRASONVILLE",
            "state": "MD",
            "postal_code": "216381400",
            "telephone_number": "410-827-8117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 MEDICAL CENTER DR",
            "city": "GRASONVILLE",
            "state": "MD",
            "postal_code": "216381400",
            "telephone_number": "410-827-8117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREVENTIVE CARE NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-02",
        "last_updated": "2019-07-02",
        "status": "A",
        "authorized_official_last_name": "HERRY",
        "authorized_official_first_name": "VICTOR",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "301-868-7333",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grasonville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2019; 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.