NPIMap

Organization Active NPI

St. Agnes Healthcare, Inc.

  • Diagnostic Radiology Physician
  • Eldersburg, MD
National Provider Identifier
1831914662
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
ST. AGNES HEALTHCARE, INC.
Practice address
6300 Georgetown Blvd
Eldersburg, MD 21784-6481
Phone
(667) 234-8675
Fax
(667) 234-8688
NPI assigned
Nov 18, 2024
Organization subpart
Yes
Parent organization
ASCENSION HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Authorized official

Name
Mr. William B Higginbotham
Title
President/Ceo
Phone
(667) 234-3162

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

6300 Georgetown Blvd
Eldersburg, MD 21784-6481

Mailing address

6300 Georgetown Blvd
Eldersburg, MD 21784-6481
Phone (667) 234-8675

Other names 1

  • Ascension Saint Agnes Imaging Eldersburg Other name

National Provider Directory

National Provider Directory
Tax ID family
Seton Medical Group41 organizations share this tax ID, including this one
Part of
Ascension Health

Other organizations with this tax ID 40

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

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1731888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731888000000",
    "number": "1831914662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 GEORGETOWN BLVD",
            "city": "ELDERSBURG",
            "state": "MD",
            "postal_code": "217846481",
            "telephone_number": "667-234-8675",
            "fax_number": "667-234-8688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 GEORGETOWN BLVD",
            "city": "ELDERSBURG",
            "state": "MD",
            "postal_code": "217846481",
            "telephone_number": "667-234-8675",
            "fax_number": "667-234-8688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. AGNES HEALTHCARE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ASCENSION HEALTH",
        "enumeration_date": "2024-11-18",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A",
        "authorized_official_last_name": "HIGGINBOTHAM",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "667-234-3162",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ascension Saint Agnes Imaging Eldersburg",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Eldersburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; 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.