NPIMap

Organization Active NPI

Statcare Group LLC

  • Urgent Care Clinic/Center
  • Reisterstown, MD
National Provider Identifier
1760097539
Registry record updated Sep 9, 2020
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Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
STATCARE GROUP LLC
Practice address
11804 Reisterstown Rd
Reisterstown, MD 21136-3311
Phone
(410) 870-5094
Fax
(410) 870-8076
NPI assigned
Sep 9, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2020

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

Authorized official

Name
Shandi Faulk
Title
Director of Billing Operations
Phone
(678) 679-6471

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

11804 Reisterstown Rd
Reisterstown, MD 21136-3311

Mailing address

1275 Highway 54 W Ste 201
Fayetteville, GA 30214-4538

Other names 1

  • ChoiceOne Urgent Care Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Statcare Group LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1599609600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1599609600000",
    "number": "1760097539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1275 HIGHWAY 54 W STE 201",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11804 REISTERSTOWN RD",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211363311",
            "telephone_number": "410-870-5094",
            "fax_number": "410-870-8076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATCARE GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-09",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-08",
        "status": "A",
        "authorized_official_last_name": "FAULK",
        "authorized_official_first_name": "SHANDI",
        "authorized_official_title_or_position": "DIRECTOR OF BILLING OPERATIONS",
        "authorized_official_telephone_number": "678-679-6471"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ChoiceOne Urgent Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Reisterstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2020; 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.