NPIMap

Organization Active NPI

Healogics Specialty Physicians of Maryland, LLC

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Leonardtown, MD
National Provider Identifier
1700288602
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianTaxonomy code 2083P0011X
Legal business name
HEALOGICS SPECIALTY PHYSICIANS OF MARYLAND, LLC
Practice address
25500 Point Lookout Rd
Leonardtown, MD 20650-2015
Phone
(240) 434-7670
NPI assigned
Sep 23, 2014
Last updated
Jun 1, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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

Authorized official

Name
Frank Williams
Title
Ceo
Phone
(904) 446-3519

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2083P0011X Primary

Addresses

Primary practice location

25500 Point Lookout Rd
Leonardtown, MD 20650-2015

Mailing address

5220 Belfort Rd
Suite 130
Jacksonville, FL 32256-6017

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20150320000856 MD Part B Supplier - Clinic/Group Practice 2365769833 Receives reassigned benefits from 14 practitioners
Practice locations: Baltimore, MD; Forest Hill, MD; Leonardtown, MD; Salisbury, MD; Solomons, MD
O20170117001003 DC Part B Supplier - Clinic/Group Practice 2365769833 Receives reassigned benefits from 6 practitioners
Practice locations: Lanham, MD; Silver Spring, MD

National Provider Directory

National Provider Directory

Locations

8100 Good Luck Rd
#2
Lanham, MD 20706

110 E Carroll St
Salisbury, MD 21801

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1411430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685577600000",
    "number": "1700288602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 BELFORT RD",
            "address_2": "SUITE 130",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322566017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25500 POINT LOOKOUT RD",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206502015",
            "telephone_number": "240-434-7670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALOGICS SPECIALTY PHYSICIANS OF MARYLAND, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-23",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "904-446-3519"
    },
    "taxonomies": [
        {
            "code": "2083P0011X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leonardtown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; 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.