NPIMap

Organization Active NPI

Meritus Medical Center Inc

Doing business as Meritus Gynecologic Oncology Center

  • Obstetrics & Gynecology Nurse Practitioner
  • Hagerstown, MD
National Provider Identifier
1679877559
Registry record updated Jul 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology Nurse PractitionerTaxonomy code 363LX0001X
Legal business name
MERITUS MEDICAL CENTER INC
Doing business as
Meritus Gynecologic Oncology Center
Practice address
11110 Medical Campus Rd
Suite 243a
Hagerstown, MD 21742-6700
Phone
(301) 665-4640
NPI assigned
Jan 6, 2011
Last updated
Jul 23, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
MERITUS MEDICAL CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 23, 2015

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

Authorized official

Name
Mr. Thomas Chan
Title
Cfo
Phone
(301) 790-8102

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Nurse Practitioner 363LX0001X NU Primary

Addresses

Primary practice location

11110 Medical Campus Rd
Suite 243a
Hagerstown, MD 21742-6700

Mailing address

11116 Medical Campus Rd
Hagerstown, MD 21742-6710

Other names 1

  • MERITUS GYNECOLOGIC ONCOLOGY CENTER Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040212000950 MD Part B Supplier - Clinic/Group Practice 7113811795 Receives reassigned benefits from 320 practitioners
18 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Fulton, MD; Ellicott City, MD; Hagerstown, MD; Severna Park, MD; Frederick, MD; Edgewater, MD; Cumberland, MD; Crownsville, MD…

Other NPIs on the same Medicare enrollment 16

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

View all 16

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

Practitioners & affiliated clinicians

Practitioners 33

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 33

NPI Registry JSON

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

{
    "created_epoch": "1294272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437609600000",
    "number": "1679877559",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11110 MEDICAL CAMPUS RD",
            "address_2": "SUITE 243A",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217426700",
            "telephone_number": "301-665-4640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERITUS MEDICAL CENTER INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MERITUS MEDICAL CENTER INC",
        "enumeration_date": "2011-01-06",
        "last_updated": "2015-07-23",
        "status": "A",
        "authorized_official_last_name": "CHAN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "301-790-8102",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "363LX0001X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MERITUS GYNECOLOGIC ONCOLOGY CENTER",
            "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 Jul 23, 2015; 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.