NPIMap

Organization Active NPI

Monocacy Health Partners LLC

Doing business as Union Bridge Family Practice

  • Family Medicine Physician
  • Union Bridge, MD
National Provider Identifier
1619245289
Registry record updated Jul 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MONOCACY HEALTH PARTNERS LLC
Doing business as
Union Bridge Family Practice
Practice address
104 N Main St
Union Bridge, MD 21791-9102
Phone
(410) 775-2622
Fax
(410) 775-2050
NPI assigned
Dec 9, 2011
Last updated
Jul 2, 2013By the provider in NPPES
Organization subpart
Yes
Parent organization
MONOCACY HEALTH PARTNERS LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 2, 2013

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

Authorized official

Name
Michelle K Mahan
Title
Sr VP and Cfo
Phone
(240) 566-3355

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

104 N Main St
Union Bridge, MD 21791-9102

Mailing address

PO Box 1110
Union Bridge, MD 21791-1110
Phone (410) 775-2622

Other names 1

  • Union Bridge Family Practice Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130820000555 MD Part B Supplier - Clinic/Group Practice 9931341096 Receives reassigned benefits from 296 practitioners
41 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Frederick, MD; Ijamsville, MD; Mount Airy, MD; Myersville, MD; Walkersville, MD; Adamstown, MD; Brunswick, MD; Emmitsburg, MD

Other NPIs on the same Medicare enrollment 40

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 40

National Provider Directory

National Provider Directory
Part of
Frederick Health Med GRP

NPI Registry JSON

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

{
    "created_epoch": "1323388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372723200000",
    "number": "1619245289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1110",
            "city": "UNION BRIDGE",
            "state": "MD",
            "postal_code": "217911110",
            "telephone_number": "410-775-2622",
            "fax_number": "410-775-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 N MAIN ST",
            "city": "UNION BRIDGE",
            "state": "MD",
            "postal_code": "217919102",
            "telephone_number": "410-775-2622",
            "fax_number": "410-775-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONOCACY HEALTH PARTNERS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MONOCACY HEALTH PARTNERS LLC",
        "enumeration_date": "2011-12-09",
        "last_updated": "2013-07-02",
        "status": "A",
        "authorized_official_last_name": "MAHAN",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "SR VP AND CFO",
        "authorized_official_telephone_number": "240-566-3355"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Union Bridge Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Union Bridge, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2013; 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.