NPIMap

Organization Active NPI

Meritus Medical Center Inc

Doing business as Dept of Behavioral Health Services-Psychiatry

  • Psychiatry Physician
  • Hagerstown, MD
National Provider Identifier
1659517936
Registry record updated Oct 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
MERITUS MEDICAL CENTER INC
Doing business as
Dept of Behavioral Health Services-Psychiatry
Practice address
11116 Medical Campus Rd
1West
Hagerstown, MD 21742-6710
Phone
(240) 313-9500
Fax
(240) 313-9530
NPI assigned
Dec 17, 2008
Last updated
Oct 26, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
MERITUS MEDICAL CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 26, 2022

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

Authorized official

Name
Joshua Repac
Title
Cfo
Phone
(301) 790-9351

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X Primary

Addresses

Primary practice location

11116 Medical Campus Rd
1West
Hagerstown, MD 21742-6710

Mailing address

11116 Medical Campus Rd
Hagerstown, MD 21742-6710
Phone (240) 313-9500

Other identifiers 1

IdentifierTypeStateIssuer
159218100MedicaidMD

Other names 1

  • DEPT OF BEHAVIORAL HEALTH SERVICES-PSYCHIATRY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Washngton Co Hos Ass-Su40 organizations share this tax ID, including this one
Part of
Washngton Co Hos Ass-Su

Other organizations with this tax ID 39

Organizations that report the same tax identification number in the National Provider Directory.

View all 39

Locations

11116 Medical Campus Rd
#1
Hagerstown, MD 21742
Phone (240) 313-9500

NPI Registry JSON

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

{
    "created_epoch": "1229472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666742400000",
    "number": "1659517936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11116 MEDICAL CAMPUS RD",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217426710",
            "telephone_number": "240-313-9500",
            "fax_number": "240-313-9530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11116 MEDICAL CAMPUS RD",
            "address_2": "1WEST",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217426710",
            "telephone_number": "240-313-9500",
            "fax_number": "240-313-9530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERITUS MEDICAL CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERITUS MEDICAL CENTER INC",
        "enumeration_date": "2008-12-17",
        "last_updated": "2022-10-26",
        "certification_date": "2022-10-26",
        "status": "A",
        "authorized_official_last_name": "REPAC",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "301-790-9351"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "159218100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "DEPT OF BEHAVIORAL HEALTH SERVICES-PSYCHIATRY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "DEPT OF BEHAVIORAL HEALTH SERVICES-PSYCHIATRY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hagerstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2022; 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.