NPIMap

Organization Active NPI

MNR Industries, LLC

  • Urgent Care Clinic/Center
  • Baltimore, MD
National Provider Identifier
1679382949
Registry record updated Apr 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
MNR INDUSTRIES, LLC
Practice address
2570 Quarry Lake Dr
Baltimore, MD 21209-3759
Phone
(443) 842-6238
Fax
(443) 842-6239
NPI assigned
Jan 2, 2025
Last updated
Apr 17, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2025

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

Authorized official

Name
Tavianna Bost
Title
Manager of Credentialing
Phone
(410) 420-6970

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

2570 Quarry Lake Dr
Baltimore, MD 21209-3759

Mailing address

1505 E Churchville Rd
Bel Air, MD 21014-4742
Phone (410) 420-6970

Other names 1

  • ExpressCare of Quarry Lake Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050204000088 MD Part B Supplier - Clinic/Group Practice 7416908843 Receives reassigned benefits from 138 practitioners
34 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Gambrills, MD; Hanover, MD; Hagerstown, MD; Hampstead, MD; Largo, MD; Laurel, MD; Loch Raven, MD; Middle River, MD…

Other NPIs on the same Medicare enrollment 33

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 33

National Provider Directory

National Provider Directory
Tax ID family
MNR Industries LLC16 organizations share this tax ID, including this one

Other organizations with this tax ID 15

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

View all 15

Locations

2570 Quarry Lake Dr
Baltimore, MD 21209
Phone (443) 842-6238

2570 Quarry Lake Dr
#72
Baltimore, MD 21209

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1735776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744848000000",
    "number": "1679382949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 E CHURCHVILLE RD",
            "city": "BEL AIR",
            "state": "MD",
            "postal_code": "210144742",
            "telephone_number": "410-420-6970",
            "fax_number": "410-420-6650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2570 QUARRY LAKE DR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212093759",
            "telephone_number": "443-842-6238",
            "fax_number": "443-842-6239"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MNR INDUSTRIES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-02",
        "last_updated": "2025-04-17",
        "certification_date": "2025-04-17",
        "status": "A",
        "authorized_official_last_name": "BOST",
        "authorized_official_first_name": "TAVIANNA",
        "authorized_official_title_or_position": "MANAGER OF CREDENTIALING",
        "authorized_official_telephone_number": "410-420-6970"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ExpressCare of Quarry Lake",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "ExpressCare of Quarry Lake",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2025; 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.