NPIMap

Organization Active NPI

Mdics at Bon Secours, LLC

  • Hospitalist Physician
  • Annapolis, MD
National Provider Identifier
1831483908
Registry record updated Jun 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospitalist PhysicianTaxonomy code 208M00000X
License
D0039037 Issued in MD
Legal business name
MDICS AT BON SECOURS, LLC
Practice address
2007 Tidewater Colony Dr
Suite 1a
Annapolis, MD 21401-2101
Phone
(443) 949-0814
Fax
(443) 949-0825
NPI assigned
Jun 6, 2011
Organization subpart
Yes
Parent organization
MDICS MANAGEMENT, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 6, 2011

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

Authorized official

Name
Dr. Doug Mitchell, M.D.
Title
Managing Director
Phone
(443) 949-0814

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208M00000X D0039037 MD Primary

Addresses

Primary practice location

2007 Tidewater Colony Dr
Suite 1a
Annapolis, MD 21401-2101

Mailing address

2007 Tidewater Colony Dr
Suite 1a
Annapolis, MD 21401-2101
Phone (443) 949-0814

National Provider Directory

National Provider Directory

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1307318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307318400000",
    "number": "1831483908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2007 TIDEWATER COLONY DR",
            "address_2": "SUITE 1A",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214012101",
            "telephone_number": "443-949-0814",
            "fax_number": "443-949-0825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2007 TIDEWATER COLONY DR",
            "address_2": "SUITE 1A",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214012101",
            "telephone_number": "443-949-0814",
            "fax_number": "443-949-0825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MDICS AT BON SECOURS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MDICS MANAGEMENT, LLC",
        "enumeration_date": "2011-06-06",
        "last_updated": "2011-06-06",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "DOUG",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "443-949-0814",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Hospitalist",
            "state": "MD",
            "license": "D0039037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2011; 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.