NPIMap

Organization Active NPI

Luminis Health Medical Group, LLC

Doing business as Anne Arundel Medical Group-Severna Park Primary Care

  • Family Medicine Physician
  • Severna Park, MD
National Provider Identifier
1588047971
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LUMINIS HEALTH MEDICAL GROUP, LLC
Doing business as
Anne Arundel Medical Group-Severna Park Primary Care
Practice address
474B Ritchie Hwy
Severna Park, MD 21146-2911
Phone
(410) 544-2940
Fax
(410) 544-2960
NPI assigned
Jul 2, 2015
Last updated
May 24, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2021

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

Authorized official

Name
Stephen Clarke
Title
Vice President
Phone
(443) 481-6549

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

474B Ritchie Hwy
Severna Park, MD 21146-2911

Mailing address

474B Ritchie Hwy
Severna Park, MD 21146-2911
Phone (410) 544-2940

Other names 1

  • Anne Arundel Medical Group-Severna Park Primary Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050317000146 MD Part B Supplier - Clinic/Group Practice 2860447315 Receives reassigned benefits from 897 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory
Tax ID family
LHMG Medical Group LLC224 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1435795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621814400000",
    "number": "1588047971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "474B RITCHIE HWY",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211462911",
            "telephone_number": "410-544-2940",
            "fax_number": "410-544-2960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "474B RITCHIE HWY",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211462911",
            "telephone_number": "410-544-2940",
            "fax_number": "410-544-2960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUMINIS HEALTH MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-02",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A",
        "authorized_official_last_name": "CLARKE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "443-481-6549"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anne Arundel Medical Group-Severna Park Primary Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Anne Arundel Medical Group-Severna Park Primary Care",
            "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 May 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.