NPIMap

Organization Active NPI

Statcare Group II, PC

Doing business as ChoiceOne Urgent Care II

  • Urgent Care Clinic/Center
  • Fallston, MD
National Provider Identifier
1558726141
Registry record updated Jul 7, 2020
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 II, PC
Doing business as
ChoiceOne Urgent Care II
Practice address
2315 Bel Air Rd
Fallston, MD 21047-2740
Phone
(410) 296-7190
Fax
(410) 296-0344
NPI assigned
Dec 23, 2015
Last updated
Jul 7, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2020

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

Authorized official

Name
Jacqueline Angela Carter
Title
Credentialing & Provider Enrollment
Phone
(410) 296-7190

Specialties & licenses 1

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

Addresses

Primary practice location

2315 Bel Air Rd
Fallston, MD 21047-2740

Mailing address

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

Other practice location 1

744 S Philadelphia Blvd Ste B
Aberdeen, MD 21001-3655
Phone (443) 345-2650

Other practice location 2

1528 Rock Spring Rd Ste 100
Forest Hill, MD 21050-2861
Phone (443) 776-1131

Other identifiers 1

IdentifierTypeStateIssuer
H0062737OtherMDLICENSE NUMBER

Other names 1

  • ChoiceOne Urgent Care II Doing business as

National Provider Directory

National Provider Directory

Locations

2315 Bel Air Rd
Fallston, MD 21047
Phone (410) 296-7190

1528 Rock Spring Rd
Ste 100
Forest Hill, MD 21050
Phone (443) 619-7555

NPI Registry JSON

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

{
    "created_epoch": "1450828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594080000000",
    "number": "1558726141",
    "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": "410-296-0344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 BEL AIR RD",
            "city": "FALLSTON",
            "state": "MD",
            "postal_code": "210472740",
            "telephone_number": "410-296-7190",
            "fax_number": "410-296-0344"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "744 S Philadelphia Blvd Ste B",
            "address_purpose": "LOCATION",
            "city": "Aberdeen",
            "state": "MD",
            "postal_code": "210013655",
            "country_code": "US",
            "telephone_number": "443-345-2650",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1528 Rock Spring Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Forest Hill",
            "state": "MD",
            "postal_code": "210502861",
            "country_code": "US",
            "telephone_number": "443-776-1131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "STATCARE GROUP II, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-23",
        "last_updated": "2020-07-07",
        "certification_date": "2020-07-07",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "ANGELA",
        "authorized_official_title_or_position": "CREDENTIALING & PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "410-296-7190"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "MD",
            "license": "H0062737",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "H0062737",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ChoiceOne Urgent Care II",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ChoiceOne Urgent Care II",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fallston, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2020; 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.