NPIMap

Organization Active NPI

Waldorf Integrated Healthcare, LLC

  • Family Medicine Physician
  • Mechanicsville, MD
National Provider Identifier
1609844018
Registry record updated Oct 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
WALDORF INTEGRATED HEALTHCARE, LLC
Doing business as
New Market Family Practice
Practice address
29015 Three Notch Rd
Suite 1-a
Mechanicsville, MD 20659-3228
Phone
(301) 290-5285
Fax
(301) 290-5287
NPI assigned
Mar 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2007

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

Authorized official

Name
Joan Barker, CMM
Title
Office Manager
Phone
(301) 645-9551

Specialties & licenses 1

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

Addresses

Primary practice location

29015 Three Notch Rd
Suite 1-a
Mechanicsville, MD 20659-3228

Mailing address

PO Box 1565
Waldorf, MD 20604-1565
Phone (301) 645-9551

Other names 1

  • New Market Family Practice Doing business as

National Provider Directory

National Provider Directory

Locations

29015 Three Notch Rd
#1A
Mechanicsville, MD 20659
Phone (301) 290-5285

29015 Three Notch Rd
Ste 1A
Mechanicsvlle, MD 20659
Phone (301) 290-5285

NPI Registry JSON

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193356800000",
    "number": "1609844018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1565",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206041565",
            "telephone_number": "301-645-9551",
            "fax_number": "301-645-0039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29015 THREE NOTCH RD",
            "address_2": "SUITE 1-A",
            "city": "MECHANICSVILLE",
            "state": "MD",
            "postal_code": "206593228",
            "telephone_number": "301-290-5285",
            "fax_number": "301-290-5287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALDORF INTEGRATED HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-10",
        "last_updated": "2007-10-26",
        "status": "A",
        "authorized_official_last_name": "BARKER",
        "authorized_official_first_name": "JOAN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "301-645-9551",
        "authorized_official_credential": "CMM"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New Market Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mechanicsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2007; 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.