Organization Active NPI

Mercy Medical Center

  • Clinical Pathology/Laboratory Medicine Physician
  • Baltimore, MD
National Provider Identifier
1710696943
Registry record updated Nov 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Pathology/Laboratory Medicine PhysicianTaxonomy code 207ZP0105X
Legal business name
MERCY MEDICAL CENTER
Practice address
301 Saint Paul PL
Baltimore, MD 21202-2165
Phone
(410) 659-2963
Fax
(410) 659-2963
NPI assigned
Nov 16, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2022

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

Authorized official

Name
Justin Deibel
Title
Chief Financial Officer
Phone
(410) 659-2905

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Pathology/Laboratory Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0105X Primary

Addresses

Primary practice location

301 Saint Paul PL
Baltimore, MD 21202-2165

Mailing address

301 St Paul Place
Medical Staff Office
Baltimore, MD 21202
Phone (410) 659-2963

Other names 1

  • Mercy Medical Center Laboratory Other name

National Provider Directory

National Provider Directory
Tax ID family
Mercy Medical Center Inc11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

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

NPI Registry JSON

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

{
    "created_epoch": "1668556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668556800000",
    "number": "1710696943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 ST PAUL PLACE",
            "address_2": "MEDICAL STAFF OFFICE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21202",
            "telephone_number": "410-659-2963",
            "fax_number": "410-659-2963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 SAINT PAUL PL",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212022165",
            "telephone_number": "410-659-2963",
            "fax_number": "410-659-2963"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MERCY MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-16",
        "last_updated": "2022-11-16",
        "certification_date": "2022-11-11",
        "status": "A",
        "authorized_official_last_name": "DEIBEL",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "410-659-2905"
    },
    "taxonomies": [
        {
            "code": "207ZP0105X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Clinical Pathology/Laboratory Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mercy Medical Center Laboratory",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2022; 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.