Old Fashion Medicine, Inc

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

D0054749 Issued in MD

Legal business name

OLD FASHION MEDICINE, INC

Practice address

95 Gatepost Lane
Apartment 1B
Frederick, MD 21701

Phone

(240) 409-3348

NPI assigned

Mar 28, 2018

Organization subpart

No

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

Authorized official

Name

John Allen Reilly, MD

Title

Owner/Physician

Phone

(240) 409-3348

Specialties & licenses 1

Addresses

Other identifiers 1

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/17304/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1522195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1649775933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16722 ANNANDALE RD",
            "city": "EMMITSBURG",
            "state": "MD",
            "postal_code": "217278908",
            "telephone_number": "240-888-5023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95 GATEPOST LANE",
            "address_2": "APARTMENT 1B",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "21701",
            "telephone_number": "240-409-3348"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "95 Gatepost Lane",
            "address_2": "Apartment 1B",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217019239",
            "country_code": "US",
            "telephone_number": "240-409-3348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "OLD FASHION MEDICINE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-28",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "REILLY",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "240-409-3348",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MD",
            "license": "D0054749",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2853027000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel Okine, BT
• Sandra Okobi
• Maryann Okolie Dione
• Oyebola Abiodun Oladeinde, PHARM. D.
• Fabio Olarte, M.D.
• Olive & Oak Wellness
• Marykay Olive, PT
• Sarah Queena D. Oliveira, NP
• Sheldon Oliver
• Alaina Olsen, MS

• Geriatric Medicine (Internal Medicine) Physician in Frederick, MD
• Providers in Frederick, MD by specialty
• Geriatric Medicine (Internal Medicine) Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.