NPIMap

Organization Active NPI

Specialty Physicians of Garrett County, LLC

  • Physician Assistant
  • McHenry, MD
National Provider Identifier
1689486847
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Legal business name
SPECIALTY PHYSICIANS OF GARRETT COUNTY, LLC
Practice address
687 Mosser Rd
MC Henry, MD 21541-1265
Phone
(301) 387-3000
Fax
(301) 387-3038
NPI assigned
Jan 24, 2025
Last updated
Jan 24, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
SPECIALTY PHYSICIANS OF GARRETT COUNTY, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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

Authorized official

Name
Lori Dixon
Title
Director, Finance
Phone
(301) 533-4251

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X NU Primary
Nurse Practitioner 363L00000X NU

Addresses

Primary practice location

687 Mosser Rd
MC Henry, MD 21541-1265

Mailing address

PO Box 1647
Morgantown, WV 26507-1647

National Provider Directory

National Provider Directory
Tax ID family
Specialty Physicians of Garrett County LLC22 organizations share this tax ID, including this one
Part of
Specialty Physicians of Garrett County LLC

Other organizations with this tax ID 21

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

View all 21

Locations

687 Mosser Rd
Mc Henry, MD 21541
Phone (301) 387-3000

NPI Registry JSON

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

{
    "created_epoch": "1737676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737676800000",
    "number": "1689486847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1647",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265071647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "687 MOSSER RD",
            "city": "MC HENRY",
            "state": "MD",
            "postal_code": "215411265",
            "telephone_number": "301-387-3000",
            "fax_number": "301-387-3038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY PHYSICIANS OF GARRETT COUNTY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPECIALTY PHYSICIANS OF GARRETT COUNTY, LLC",
        "enumeration_date": "2025-01-24",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A",
        "authorized_official_last_name": "DIXON",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "DIRECTOR, FINANCE",
        "authorized_official_telephone_number": "301-533-4251"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McHenry, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2025; 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.