NPIMap

Organization Active NPI

Frederick Anesthesia, LLC

  • Anesthesiology Physician
  • Frederick, MD
National Provider Identifier
1639283757
Registry record updated Oct 16, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
FREDERICK ANESTHESIA, LLC
Practice address
85 Thomas Johnson CT
Suite E
Frederick, MD 21702-4331
Phone
(301) 668-1600
Fax
(301) 829-7694
NPI assigned
Aug 18, 2006
Last updated
Oct 16, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2007

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

Authorized official

Name
Dr. David Lee Jordan, M.D.
Title
President
Phone
(301) 829-7683

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU Primary

Addresses

Primary practice location

85 Thomas Johnson CT
Suite E
Frederick, MD 21702-4331

Mailing address

602 Center St
Suite 107
Mount Airy, MD 21771-7420
Phone (301) 829-7683

Other identifiers 4

IdentifierTypeStateIssuer
230BFROtherMDCAREFIRST PAR PROVIDER #
CA7369OtherMDRR MEDICARE
K297OtherDCCAREFIRST PAR PROVIDER #
DC6641OtherDCRAILROAD PAR GROUP #

National Provider Directory

National Provider Directory

Locations

602 Center St
Ste 107
Mount Airy, MD 21771

Practitioners & affiliated clinicians

Practitioners 7

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": "1155859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192492800000",
    "number": "1639283757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 CENTER ST",
            "address_2": "SUITE 107",
            "city": "MOUNT AIRY",
            "state": "MD",
            "postal_code": "217717420",
            "telephone_number": "301-829-7683",
            "fax_number": "301-829-7694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 THOMAS JOHNSON CT",
            "address_2": "SUITE E",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024331",
            "telephone_number": "301-668-1600",
            "fax_number": "301-829-7694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREDERICK ANESTHESIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-18",
        "last_updated": "2007-10-16",
        "status": "A",
        "authorized_official_last_name": "JORDAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-829-7683",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST PAR PROVIDER #",
            "identifier": "230BFR",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "CA7369",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST PAR PROVIDER #",
            "identifier": "K297",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD PAR GROUP #",
            "identifier": "DC6641",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.