Broadmead Medical Services, Inc

Primary specialty

Geriatric Medicine (Family Medicine) PhysicianTaxonomy code 207QG0300X

Legal business name

BROADMEAD MEDICAL SERVICES, INC

Practice address

13801 York Rd
Cockeysville, MD 21030-1825

Phone

(410) 527-1900

Fax

(410) 527-3516

NPI assigned

Nov 29, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Shelley Ann Hubbert, CPC

Title

Medical Billing/Accounting Dept.

Phone

(443) 578-8043

Specialties & licenses 3

Addresses

Other identifiers 1

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

{
    "created_epoch": "1133222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261008000000",
    "number": "1801879390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13801 YORK RD",
            "city": "COCKEYSVILLE",
            "state": "MD",
            "postal_code": "210301825",
            "telephone_number": "410-527-1900",
            "fax_number": "410-527-3516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13801 YORK RD",
            "city": "COCKEYSVILLE",
            "state": "MD",
            "postal_code": "210301825",
            "telephone_number": "410-527-1900",
            "fax_number": "410-527-3516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROADMEAD MEDICAL SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-29",
        "last_updated": "2009-12-17",
        "status": "A",
        "authorized_official_last_name": "HUBBERT",
        "authorized_official_first_name": "SHELLEY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "MEDICAL BILLING/ACCOUNTING DEPT.",
        "authorized_official_telephone_number": "443-578-8043",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CPC"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSSBLUESHIELD",
            "identifier": "6902000000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Geriatric Medicine (Family Medicine) Physician in Cockeysville, MD
• Providers in Cockeysville, MD by specialty
• Geriatric Medicine (Family Medicine) Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2009; 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.