Organization Active NPI

Newbridge Spine and Pain Center LLC

  • Specialist
  • Frederick, MD
National Provider Identifier
1790921450
Registry record updated Aug 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
NEWBRIDGE SPINE AND PAIN CENTER LLC
Practice address
196 Thomas Johnson Dr
Suite 215
Frederick, MD 21702-4397
Phone
(301) 668-9988
Fax
(301) 668-9977
NPI assigned
Dec 31, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2025

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

Authorized official

Name
Debra Turner
Title
Coo
Phone
(240) 651-3986

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

196 Thomas Johnson Dr
Suite 215
Frederick, MD 21702-4397

Mailing address

196 Thomas Johnson Dr
Suite 215
Frederick, MD 21702-4397
Phone (301) 668-9988

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090917000613 MD Part B Supplier - Clinic/Group Practice 7113073024 Receives reassigned benefits from 6 practitioners
Practice locations: Waldorf, MD; Prince Frederick, MD; Frederick, MD

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D1101650Newbridge Spine and Pain Center LLC196 Thomas Johnson Drive Suite 215, Frederick, MD 21702Certificate of waiverJun 30, 2027

National Provider Directory

National Provider Directory

Locations

196 Thomas Johnson Dr
Ste 215
Frederick, MD 21702
Phone (301) 668-9988

5330 Spectrum Dr
Ste I
Frederick, MD 21703
Phone (240) 396-4343

Practitioners & affiliated clinicians

Practitioners 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1230681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1754438400000",
    "number": "1790921450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 THOMAS JOHNSON DR",
            "address_2": "SUITE 215",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024397",
            "telephone_number": "301-668-9988",
            "fax_number": "301-668-9977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "196 THOMAS JOHNSON DR",
            "address_2": "SUITE 215",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024397",
            "telephone_number": "301-668-9988",
            "fax_number": "301-668-9977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEWBRIDGE SPINE AND PAIN CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-31",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A",
        "authorized_official_last_name": "TURNER",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "240-651-3986"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.