Kimbrough Amblatory Care Center

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

License

R168995 Issued in MD

Legal business name

KIMBROUGH AMBLATORY CARE CENTER

Practice address

2480 Llewellyn Ave Ste 5800
Fort George G Meade, MD 20755-5129

Phone

(301) 677-8670

NPI assigned

May 27, 2009

Last updated

May 27, 2009By 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

Mrs. Jennifer Stacy-Bonot, B.S.N.

Title

Nurse

Phone

(301) 677-8670

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1243382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243382400000",
    "number": "1831324441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2480 LLEWELLYN AVE STE 5800",
            "city": "FORT GEORGE G MEADE",
            "state": "MD",
            "postal_code": "207555129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2480 LLEWELLYN AVE STE 5800",
            "city": "FORT GEORGE G MEADE",
            "state": "MD",
            "postal_code": "207555129",
            "telephone_number": "301-677-8670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIMBROUGH AMBLATORY CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-27",
        "last_updated": "2009-05-27",
        "status": "A",
        "authorized_official_last_name": "STACY-BONOT",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "NURSE",
        "authorized_official_telephone_number": "301-677-8670",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "B.S.N."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "MD",
            "license": "R168995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah E Jones, PMHNP
• Suzanne Jones, DDS
• Heidi Carin Nielsen Kaufman, LRD
• Case Keltner
• Jean B Kim, RN
• Kimbrough Ambulatory Care Center
• Casey Kara King, LCSW-C
• Laura Anne Kocan, MS, CCC-SLP
• Mark J Krist, LCSW
• Darlene E Kuroda

• Urgent Care Clinic/Center in Fort George G Meade, MD
• Providers in Fort George G Meade, MD by specialty
• Urgent Care Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 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.