NPIMap

Organization Active NPI

Maryland Spine and Brain Specialists, LLC

  • Specialist
  • Elkridge, MD
National Provider Identifier
1639359508
Registry record updated May 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
D53752 Issued in MD
Legal business name
MARYLAND SPINE AND BRAIN SPECIALISTS, LLC
Practice address
8178 Lark Brown Rd Ste 101
Elkridge, MD 21075-6438
Phone
(410) 646-4800
Fax
(410) 646-9700
NPI assigned
Nov 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 21, 2026

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

Authorized official

Name
Brittany Tilman
Title
Office Manager
Phone
(410) 646-4800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X D53752 MD Primary

Addresses

Primary practice location

8178 Lark Brown Rd Ste 101
Elkridge, MD 21075-6438

Mailing address

8178 Lark Brown Rd Ste 101
Elkridge, MD 21075-6438
Phone (410) 646-4800

Other identifiers 1

IdentifierTypeStateIssuer
633102500MedicaidMD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041104000764 MD Part B Supplier - Clinic/Group Practice 0547223216 Receives reassigned benefits from 6 practitioners
Practice locations: Columbia, MD; Elkridge, MD; Baltimore, MD

National Provider Directory

National Provider Directory

Locations

11055 Little Patuxent Pkwy
#1
Columbia, MD 21044

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22084/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 6

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": "1194480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779321600000",
    "number": "1639359508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8178 LARK BROWN RD STE 101",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210756438",
            "telephone_number": "410-646-4800",
            "fax_number": "410-646-9700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8178 LARK BROWN RD STE 101",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210756438",
            "telephone_number": "410-646-4800",
            "fax_number": "410-646-9700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND SPINE AND BRAIN SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-08",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "status": "A",
        "authorized_official_last_name": "TILMAN",
        "authorized_official_first_name": "BRITTANY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "410-646-4800"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MD",
            "license": "D53752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "633102500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkridge, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2026; 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.