Southern Maryland House Calls, LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

SOUTHERN MARYLAND HOUSE CALLS, LLC

Practice address

45088 Blackistone Cir
Hollywood, MD 20636-2891

Phone

(240) 587-7275

Fax

(240) 587-6600

NPI assigned

Feb 6, 2023

Organization subpart

No

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

Authorized official

Name

Ms. Stephanie Anne Shepard, PA-CNPI 1396705174

Title

Owner/Physician Assistant

Phone

(240) 587-7275

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Stephanie Anne Shepard, PA

  • Physician Assistant
  • Fairfax, VA
  • NPI 1396705174

  MD

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1675641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680739200000",
    "number": "1669178018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24351 MERVELL DEAN RD UNIT 161",
            "city": "HOLLYWOOD",
            "state": "MD",
            "postal_code": "206367507",
            "telephone_number": "240-587-7275",
            "fax_number": "240-587-6600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45088 BLACKISTONE CIR",
            "city": "HOLLYWOOD",
            "state": "MD",
            "postal_code": "206362891",
            "telephone_number": "240-587-7275",
            "fax_number": "240-587-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN MARYLAND HOUSE CALLS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-06",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A",
        "authorized_official_last_name": "SHEPARD",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN ASSISTANT",
        "authorized_official_telephone_number": "240-587-7275",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vinaychandra Shah
• Connor Shelton
• William A Sherman Jr., PH.D.
• Kristina Sarah Smith, PT
• Southern Maryland Counseling, LLC
• Oluseun Sowemimo
• St Johns Pharmacy Inc
• St. Mary'S Adult Medical Day Care
• St. Mary'S County Gov'T, Dept. of Aging, Medical Adult Day Services
• Step N2 Recovery Services

• Health Service Clinic/Center in Hollywood, MD
• Providers in Hollywood, MD by specialty
• Health Service Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2023; 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.