Shady Grove Orthopaedic Assoc, PA

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

D0002443 Issued in MD

Legal business name

SHADY GROVE ORTHOPAEDIC ASSOC, PA

Practice address

9601 Blackwell Road Suite 100
Rockville, MD 20850-3241

Phone

(301) 340-0072

Fax

(301) 279-9358

NPI assigned

Feb 23, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Steven L Tuck, MD

Title

President

Phone

(301) 340-0072

Specialties & licenses 1

Addresses

Other identifiers 5

Locations

Practitioners 1

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

• Stephen W Jones, MD

  • Family Medicine Physician
  • Shelby, NC
  • NPI 1730130881
  NPD (past)

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1603411200000",
    "number": "1669448437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9601 BLACKWELL ROAD SUITE 100",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503241",
            "telephone_number": "301-340-0072",
            "fax_number": "301-279-9358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9601 BLACKWELL ROAD SUITE 100",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503241",
            "telephone_number": "301-340-0072",
            "fax_number": "301-279-9358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADY GROVE ORTHOPAEDIC ASSOC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-23",
        "last_updated": "2020-10-23",
        "certification_date": "2020-10-23",
        "status": "A",
        "authorized_official_last_name": "TUCK",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-340-0072",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "MD",
            "license": "D0002443",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF NCA",
            "identifier": "4661",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF MARYLAND",
            "identifier": "H840SH",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "225292",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ADMINISTAR FEDERAL",
            "identifier": "0549770001",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "C10224",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shady Grove Dermatology
• Shady Grove Eye & Vision Care, LLC
• Shady Grove Family Health Care Inc
• Shady Grove Fertility Reproductive Science Center
• Shady Grove Hyperbaric Medicine
• Shady Grove Pediatric Associates
• Shady Grove Reproductive Science Center PC
• Shady Grove SNF LLC
• Shady Grove SNF LLC
• Shady Grove SNF LLC

• Orthopaedic Surgery Physician in Rockville, MD
• Providers in Rockville, MD by specialty
• Orthopaedic Surgery Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2020; 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.