Darryl Spencer Slack, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

C0000715 Issued in MD

Practice address

11110 Medical Campus Road, Suite 147
Meritus Health System
Hagerstown, MD 21742

Phone

(240) 313-9600

Fax

(240) 313-9601

NPI assigned

Aug 16, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Barnett Medical, LLC

  • Internal Medicine Physician
  • Frederick, MD
  • NPI 1285827881
  NPD (past)
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)
• Susan B. Brinkley, LLC

  • Internal Medicine Physician
  • Frederick, MD
  • NPI 1912191719
  NPD (past)

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379462400000",
    "number": "1801909650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12911 CLOPPER RD",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217424811",
            "telephone_number": "240-527-4378",
            "fax_number": "240-313-9601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11110 MEDICAL CAMPUS ROAD, SUITE 147",
            "address_2": "MERITUS HEALTH SYSTEM",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "21742",
            "telephone_number": "240-313-9600",
            "fax_number": "240-313-9601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLACK",
        "first_name": "DARRYL",
        "middle_name": "SPENCER",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2013-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C0000715",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE #",
            "identifier": "C0000715",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diamond Sines
• Harpreet Singh, RPH
• Danielle Yvette Singleton, M.D.
• Quirina CHI Sinye
• Frank Slabinski
• Jason Slack, D.O.
• Colleen Slaton, OTR/L
• Sleepmed Therapies, Inc.
• John Michael Slick, LGPC
• Kelly Robynn Slocum, P.T.

• Medical Physician Assistant in Hagerstown, MD
• Providers in Hagerstown, MD by specialty
• Medical Physician Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2013; 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.