Active NPI
Healogics Specialty Physicians of Maryland, LLC
- Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
- Leonardtown, MD
National Provider Identifier
1700288602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
- 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
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Undersea and Hyperbaric Medicine (Preventive Medicine) Physician | 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, DC
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 DirectoryLocations
8100 Good Luck Rd
#2
Lanham, MD 20706
11890 Healing Way
Ste 1210
Silver Spring, MD 20904
Phone (240) 637-5908
Practitioners & affiliated clinicians
Practitioners 15
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
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.