Laurel Lakes Foot and Ankle Center, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

00560 Issued in MD

Legal business name

LAUREL LAKES FOOT AND ANKLE CENTER, LLC

Practice address

13950 Baltimore Ave
Laurel, MD 20707-5000

Phone

(301) 317-6800

NPI assigned

Oct 7, 2008

Last updated

Oct 7, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Scott W. NutterNPI 1972782142

Title

DPM

Phone

(301) 317-6800

Specialties & licenses 1

Addresses

Other identifiers 9

Practitioners 1

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.

• Scott W Nutter

  • Podiatrist
  • Laurel, MD
  • NPI 1972782142
  NPD Authorized official

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

{
    "created_epoch": "1223337600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223337600000",
    "number": "1770734915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13950 BALTIMORE AVE",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075000",
            "telephone_number": "301-317-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13950 BALTIMORE AVE",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075000",
            "telephone_number": "301-317-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAUREL LAKES FOOT AND ANKLE CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-07",
        "last_updated": "2008-10-07",
        "status": "A",
        "authorized_official_last_name": "NUTTER",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "W.",
        "authorized_official_title_or_position": "DPM",
        "authorized_official_telephone_number": "301-317-6800",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MD",
            "license": "00560",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF VA",
            "identifier": "252513",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "91242",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF DC",
            "identifier": "0001",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF MD",
            "identifier": "41866201",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7998686000",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "91242",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "998E",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERGROUP",
            "identifier": "A050",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPPO",
            "identifier": "496067",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laurel Eye Care LLC (Pearle Vision)
• Laurel Foot and Ankle Center
• Laurel Foot and Ankle Center, LLC
• Laurel Lakes Cosmetic Dentistry
• Laurel Lakes Foot and Ankle ASC
• Laurel Lakes Pediatric Dentistry, LLC (Laurel Lakes Pediatric Dentistry)
• Laurel Lakes Primary Care, LLC
• Laurel Main Street Pharmacy (Main Street Pharmacy)
• Laurel Main Street Pharmacy Incorporated
• Laurel Main Street Pharmacy Incorporated (Main Street Pharmacy)

• Ambulatory Surgical Clinic/Center in Laurel, MD
• Providers in Laurel, MD by specialty
• Ambulatory Surgical Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2008; 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.