Organization Active NPI

Laurel Medical Associates, LLC

  • Internal Medicine Physician
  • Laurel, MD
National Provider Identifier
1609064047
Registry record updated Feb 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
0053235 Issued in MD
Legal business name
LAUREL MEDICAL ASSOCIATES, LLC
Practice address
13635 Baltimore Ave
Laurel, MD 20707-5095
Phone
(301) 497-0401
Fax
(301) 497-0402
NPI assigned
Oct 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2014

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

Authorized official

Name
Dr. Darryl Anthony Hill, MDNPI 1013978790
Title
Medical Director
Phone
(301) 497-0401

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: 193400000X SINGLE SPECIALTY GROUP 207R00000X 0053235 MD Primary

Addresses

Primary practice location

13635 Baltimore Ave
Laurel, MD 20707-5095

Mailing address

13635 Baltimore Ave
Laurel, MD 20707-5095
Phone (301) 497-0401

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20060503000218 MD Part B Supplier - Clinic/Group Practice 7113937327 Receives reassigned benefits from 1 practitioner
Practice locations: Laurel, MD
O20120328000364 DC Part B Supplier - Clinic/Group Practice 7113937327 Receives reassigned benefits from 1 practitioner
Practice locations: Laurel, MD

National Provider Directory

National Provider Directory

Locations

13635 Baltimore Ave
Laurel, MD 20707
Phone (301) 497-0401

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/17239/brand/1/csg/1/fhir/r4

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": "1191974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392940800000",
    "number": "1609064047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13635 BALTIMORE AVE",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075095",
            "telephone_number": "301-497-0401",
            "fax_number": "301-497-0402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13635 BALTIMORE AVE",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075095",
            "telephone_number": "301-497-0401",
            "fax_number": "301-497-0402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAUREL MEDICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-10",
        "last_updated": "2014-02-21",
        "status": "A",
        "authorized_official_last_name": "HILL",
        "authorized_official_first_name": "DARRYL",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "301-497-0401",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "0053235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2014; 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.