NPIMap

Organization Active NPI

Miles River Primary Care LLC

  • Family Medicine Physician
  • Cambridge, MD
National Provider Identifier
1699594044
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MILES RIVER PRIMARY CARE LLC
Practice address
618 Sunburst Hwy
Cambridge, MD 21613-2546
Phone
(667) 372-0228
Fax
(410) 822-9513
NPI assigned
Oct 3, 2024
Organization subpart
Yes
Parent organization
MILES RIVER PRIMARY CARE LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Authorized official

Name
Mrs. Tammy Smith
Title
Business Manager
Phone
(410) 822-9133

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

618 Sunburst Hwy
Cambridge, MD 21613-2546

Mailing address

618 Sunburst Hwy
Cambridge, MD 21613-2546

Other names 2

  • Miles River Physicians Former legal business name
  • MR DOCS Other name

National Provider Directory

National Provider Directory
Part of
Miles River Physicians

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1727913600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727913600000",
    "number": "1699594044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "618 SUNBURST HWY",
            "city": "CAMBRIDGE",
            "state": "MD",
            "postal_code": "216132546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "618 SUNBURST HWY",
            "city": "CAMBRIDGE",
            "state": "MD",
            "postal_code": "216132546",
            "telephone_number": "667-372-0228",
            "fax_number": "410-822-9513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILES RIVER PRIMARY CARE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MILES RIVER PRIMARY CARE LLC",
        "enumeration_date": "2024-10-03",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "410-822-9133",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Miles River Physicians",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "MR DOCS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Cambridge, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; 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.