NPIMap

Organization Active NPI

Heart Center of Southern Maryland

  • Physician Assistant
  • Waldorf, MD
National Provider Identifier
1568917383
Registry record updated Aug 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Legal business name
HEART CENTER OF SOUTHERN MARYLAND
Practice address
3510 Old Washington Rd
Suite 100
Waldorf, MD 20602-3233
Phone
(301) 645-4793
NPI assigned
Aug 22, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2016

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

Authorized official

Name
Gopalakrishnan Srinivasan, M.D
Title
Ceo
Phone
(301) 645-4793

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363A00000X MD Primary

Addresses

Primary practice location

3510 Old Washington Rd
Suite 100
Waldorf, MD 20602-3233

Mailing address

3510 Old Washington Rd
Suite 100
Waldorf, MD 20602-3233

National Provider Directory

National Provider Directory

Locations

3510 Old Washington Rd
Ste 100
Waldorf, MD 20602
Phone (301) 609-5200

NPI Registry JSON

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

{
    "created_epoch": "1471824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471824000000",
    "number": "1568917383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3510 OLD WASHINGTON RD",
            "address_2": "SUITE 100",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3510 OLD WASHINGTON RD",
            "address_2": "SUITE 100",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023233",
            "telephone_number": "301-645-4793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEART CENTER OF SOUTHERN MARYLAND",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-22",
        "last_updated": "2016-08-22",
        "status": "A",
        "authorized_official_last_name": "SRINIVASAN",
        "authorized_official_first_name": "GOPALAKRISHNAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "301-645-4793",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2016; 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.