NPIMap

Organization Active NPI

Maryland Primary Care and Wellness

  • Internal Medicine Physician
  • Silver Spring, MD
National Provider Identifier
1578371514
Registry record updated Dec 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MARYLAND PRIMARY CARE AND WELLNESS
Practice address
3921 Ferrara Dr
Silver Spring, MD 20906-4709
Phone
(301) 946-6420
NPI assigned
Dec 23, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2024

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

Authorized official

Name
Albert Enow TakemNPI 1437414455
Title
MD
Phone
(240) 408-6286

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: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

3921 Ferrara Dr
Silver Spring, MD 20906-4709

Mailing address

3921 Ferrara Dr
Silver Spring, MD 20906-4709

Other identifiers 2

IdentifierTypeStateIssuer
924025000MedicaidMD
924034900MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
Maryland Prim Care and WLNS5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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": "1734912000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734912000000",
    "number": "1578371514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3921 FERRARA DR",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209064709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3921 FERRARA DR",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209064709",
            "telephone_number": "301-946-6420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND PRIMARY CARE AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-23",
        "last_updated": "2024-12-23",
        "certification_date": "2024-12-23",
        "status": "A",
        "authorized_official_last_name": "TAKEM",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_middle_name": "ENOW",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "240-408-6286"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "924025000",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "924034900",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2024; 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.