Thomas Johnson Surgery Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

A1465 Issued in MD

Legal business name

THOMAS JOHNSON SURGERY CENTER, LLC

Practice address

197 Thomas Johnson Dr
Frederick, MD 21702-4314

Phone

(301) 631-3881

Fax

(301) 631-3883

NPI assigned

Dec 23, 2007

Organization subpart

No

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

Authorized official

Name

Ravi Yalamanchili, M.D.

Title

President

Phone

(301) 846-0100

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Listed as

Thomas Johnson Surgery CenterCCN 21C0001465

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1198368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1236038400000",
    "number": "1679757959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "197 THOMAS JOHNSON DR",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024314",
            "telephone_number": "301-631-3881",
            "fax_number": "301-631-3883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "197 THOMAS JOHNSON DR",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024314",
            "telephone_number": "301-631-3881",
            "fax_number": "301-631-3883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS JOHNSON SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-23",
        "last_updated": "2009-03-03",
        "status": "A",
        "authorized_official_last_name": "YALAMANCHILI",
        "authorized_official_first_name": "RAVI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-846-0100",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MD",
            "license": "A1465",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Therapeutic Soulutions, Inc.
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• Casandra Elaine Theriault, LGSW
• Thespacebetweenpsychotherapy, LLC
• Thomas Johnson Pharmacy
• Renee A Thomas-Spencer, MD
• Anjali Elizabeth Thomas
• Derek Blair Thomas
• Elijah Thomas
• Hallie Thomas, PA-C

• Ambulatory Surgical Clinic/Center in Frederick, MD
• Providers in Frederick, MD by specialty
• Ambulatory Surgical Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.