NPIMap

Organization Active NPI

USA Sleep Diagnostic Mobile Services, LLC

  • Sleep Disorder Diagnostic Clinic/Center
  • Columbia, MD
National Provider Identifier
1598104010
Registry record updated Mar 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Disorder Diagnostic Clinic/CenterTaxonomy code 261QS1200X
License
20179 Issued in MD
Legal business name
USA SLEEP DIAGNOSTIC MOBILE SERVICES, LLC
Practice address
9520 Berger Rd
Suite 212
Columbia, MD 21046-1501
Phone
(888) 792-4445
Fax
(888) 756-6615
NPI assigned
Jun 18, 2013
Last updated
Mar 17, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2020

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

Authorized official

Name
Mr. Thurlyn Bryan Wilson
Title
Owner
Phone
(888) 792-4445

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Disorder Diagnostic Clinic/Center 261QS1200X 20179 MD Primary

Addresses

Primary practice location

9520 Berger Rd
Suite 212
Columbia, MD 21046-1501

Mailing address

6030 Daybreak Cir
Ste a-150,260
Clarksville, MD 21029-1642
Phone (888) 792-4445

Other practice location 1

1215 Annapolis Rd Ste 202
Odenton, MD 21113-1349
Phone (888) 792-4445

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161102002022 MD Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 4284956335 Practice locations: Odenton, MD

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1371513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584403200000",
    "number": "1598104010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6030 DAYBREAK CIR",
            "address_2": "STE A-150,260",
            "city": "CLARKSVILLE",
            "state": "MD",
            "postal_code": "210291642",
            "telephone_number": "888-792-4445",
            "fax_number": "888-756-6615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9520 BERGER RD",
            "address_2": "SUITE 212",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210461501",
            "telephone_number": "888-792-4445",
            "fax_number": "888-756-6615"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1215 Annapolis Rd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Odenton",
            "state": "MD",
            "postal_code": "211131349",
            "country_code": "US",
            "telephone_number": "888-792-4445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "USA SLEEP DIAGNOSTIC MOBILE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-18",
        "last_updated": "2020-03-17",
        "certification_date": "2020-03-17",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "THURLYN",
        "authorized_official_middle_name": "BRYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "888-792-4445",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": "MD",
            "license": "20179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2020; 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.