Somerville Surgical, LLC

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

Legal business name

SOMERVILLE SURGICAL, LLC

Practice address

10700 Charter Dr Ste 200
Columbia, MD 21044-3629

Phone

(410) 446-7431

Fax

(410) 910-2310

NPI assigned

Aug 9, 2019

Organization subpart

No

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

Authorized official

Name

Justin Somerville, MD

Title

Owner

Phone

(410) 910-2310

Specialties & licenses 1

Addresses

Electronic endpoints 1

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

{
    "created_epoch": "1565308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1565308800000",
    "number": "1700431368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 LYON CT",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212081195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10700 CHARTER DR STE 200",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210443629",
            "telephone_number": "410-446-7431",
            "fax_number": "410-910-2310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOMERVILLE SURGICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-09",
        "last_updated": "2019-08-09",
        "status": "A",
        "authorized_official_last_name": "SOMERVILLE",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-910-2310",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Colon & Rectal Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "drjsomerville@gmail.com",
            "affiliation": "N",
            "address_1": "10700 Charter Dr Ste 200",
            "city": "Columbia",
            "state": "MD",
            "country_code": "US",
            "postal_code": "210443629",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Solutions for Mindfulness PA
• Solutions for Mindfulness, PA
• Solutions for Mindfulness, PA
• Jill Somers
• Kenna Somers
• Johnette C Somerville, RN
• Justin Colin Somerville, M.D.
• Ah Reum Son
• Amanda Yi Son
• Mingxin Song, LIC. AC.

• Colon & Rectal Surgery Physician in Columbia, MD
• Providers in Columbia, MD by specialty
• Colon & Rectal Surgery Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2019; 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.