Meadow Mountain Health, LLC

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Legal business name

MEADOW MOUNTAIN HEALTH, LLC

Practice address

8739 Rock Lodge Rd
Accident, MD 21520-1126

Phone

(410) 726-1443

NPI assigned

Oct 2, 2023

Organization subpart

No

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

Authorized official

Name

Shannon L Trego, PA-CNPI 1700209418

Title

Owner / Physician Assistant

Phone

(410) 726-1443

Specialties & licenses 1

Addresses

Practitioners 1

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

• Shannon Leigh Trego, PA-C

  • Physician Assistant
  • Accident, MD
  • NPI 1700209418
  NPD Authorized official

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

{
    "created_epoch": "1696204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696204800000",
    "number": "1689454191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8739 ROCK LODGE RD",
            "city": "ACCIDENT",
            "state": "MD",
            "postal_code": "215201126",
            "telephone_number": "410-726-1443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8739 ROCK LODGE RD",
            "city": "ACCIDENT",
            "state": "MD",
            "postal_code": "215201126",
            "telephone_number": "410-726-1443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEADOW MOUNTAIN HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-02",
        "last_updated": "2023-10-02",
        "certification_date": "2023-09-29",
        "status": "A",
        "authorized_official_last_name": "TREGO",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER / PHYSICIAN ASSISTANT",
        "authorized_official_telephone_number": "410-726-1443",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Yvonne Larose Cuppett, CD(DONA)
• Thomas F Gregory, DDS, PHD
• Benjamin Kenneth Kelly, LAT, ATC, ITAT
• Pamela Margroff
• Allyson Holler Martz, DED
• Walter Karl Naumann, M.D.
• Jennifer Anne Nitzsche, LPN
• Privia Medical Group, LLC
• Root Cause Health LLC
• Terry J Stough, ATC

• Physician Assistant in Accident, MD
• Providers in Accident, MD by specialty
• Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; 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.