NPIMap

Organization Active NPI

Maryland Pain and Wellness Center

  • Interventional Pain Medicine Physician
  • Crofton, MD
National Provider Identifier
1821356023
Registry record updated Oct 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
Legal business name
MARYLAND PAIN AND WELLNESS CENTER
Practice address
2200 Defense Hwy Ste 203
Crofton, MD 21114-2927
Phone
(973) 392-7703
NPI assigned
Apr 25, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2018

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

Authorized official

Name
Henry A AchampongNPI 1073740726
Title
Owner
Phone
(973) 392-7703

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X Primary

Addresses

Primary practice location

2200 Defense Hwy Ste 203
Crofton, MD 21114-2927

Mailing address

2200 Defense Hwy Ste 203
Crofton, MD 21114-2927
Phone (973) 392-7703

Other practice location 1

5901 Montrose Rd
#s1006
Rockville, MD 20852-4753
Phone (973) 392-7703

Other practice location 2

106 Milford Street
Stu 503
Salisbury, MD 21804-6958
Phone (443) 584-4336

Other practice location 3

7413 Arrowood Rd
Bethesda, MD 20817-2822
Phone (301) 926-8400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120511000397 DC Part B Supplier - Clinic/Group Practice 6103089024 Receives reassigned benefits from 1 practitioner
Practice locations: Bethesda, MD
O20150624002680 MD Part B Supplier - Clinic/Group Practice 6103089024 Receives reassigned benefits from 2 practitioners
Practice locations: Crofton, MD; Salisbury, 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
21D2099930Maryland Pain and Spine Wellness Ctr106 Milford Street Suite 503, Salisbury, MD 21804Certificate of waiverAug 4, 2027

National Provider Directory

National Provider Directory
Tax ID family
Maryland Pain and Wellness Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

106 Milford St
Ste 503
Salisbury, MD 21804
Phone (410) 546-4300

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1335312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540944000000",
    "number": "1821356023",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 DEFENSE HWY STE 203",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211142927",
            "telephone_number": "973-392-7703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 DEFENSE HWY STE 203",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211142927",
            "telephone_number": "973-392-7703"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5901 Montrose Rd",
            "address_2": "#s1006",
            "address_purpose": "LOCATION",
            "city": "Rockville",
            "state": "MD",
            "postal_code": "208524753",
            "country_code": "US",
            "telephone_number": "973-392-7703",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "106 Milford Street",
            "address_2": "STU 503",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "MD",
            "postal_code": "218046958",
            "country_code": "US",
            "telephone_number": "443-584-4336",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7413 Arrowood Rd",
            "address_purpose": "LOCATION",
            "city": "Bethesda",
            "state": "MD",
            "postal_code": "208172822",
            "country_code": "US",
            "telephone_number": "301-926-8400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MARYLAND PAIN AND WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-25",
        "last_updated": "2018-10-31",
        "status": "A",
        "authorized_official_last_name": "ACHAMPONG",
        "authorized_official_first_name": "HENRY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "973-392-7703"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crofton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2018; 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.