NPIMap

Organization Active NPI

Mep Observation Services LLC

  • Internal Medicine Physician
  • Rockville, MD
National Provider Identifier
1740021625
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MEP OBSERVATION SERVICES LLC
Practice address
9901 Medical Center Dr
Rockville, MD 20850-3357
Phone
(844) 474-4019
NPI assigned
Jun 4, 2024
Last updated
Dec 18, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Authorized official

Name
Jennifer Chastain
Title
Provider Enrollment
Phone
(330) 493-4443

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

9901 Medical Center Dr
Rockville, MD 20850-3357

Mailing address

4535 Dressler Rd NW
Canton, OH 44718-2545
Phone (844) 474-4019

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120921000196 DC Part B Supplier - Clinic/Group Practice 2365611845 Receives reassigned benefits from 55 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rockville, MD

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 101

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 101

NPI Registry JSON

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

{
    "created_epoch": "1717459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734480000000",
    "number": "1740021625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4535 DRESSLER RD NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182545",
            "telephone_number": "844-474-4019",
            "fax_number": "330-493-8677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9901 MEDICAL CENTER DR",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503357",
            "telephone_number": "844-474-4019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEP OBSERVATION SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-04",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A",
        "authorized_official_last_name": "CHASTAIN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "330-493-4443"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; 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.