NPIMap

Organization Active NPI

Union Hospital of Cecil County, Inc.

  • Family Medicine Physician
  • Elkton, MD
National Provider Identifier
1831940980
Registry record updated Mar 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
UNION HOSPITAL OF CECIL COUNTY, INC.
Practice address
111 W High St Ste 314
Elkton, MD 21921-8617
Phone
(410) 620-0545
NPI assigned
Mar 28, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2024

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

Authorized official

Name
Judy Riesen
Title
Corporate Director of Revenue Cycle
Phone
(302) 623-7168

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

111 W High St Ste 314
Elkton, MD 21921-8617

Mailing address

207 North St
Elkton, MD 21921-5512
Phone (410) 398-3868

Other names 1

  • Union Primary Care of Elkton Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040121001109 MD Part B Supplier - Clinic/Group Practice 6901719822 Receives reassigned benefits from 546 practitioners
22 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rising Sun, MD; Perryville, MD; North East, MD; Elkton, MD

Other NPIs on the same Medicare enrollment 22

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 22

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
21D0981541Union Primary Care of Elkton111 West High Street Ste 314, Elkton, MD 21921Provider-performed microscopyJan 1, 2027

National Provider Directory

National Provider Directory
Tax ID family
U H C C-Psychiatry38 organizations share this tax ID, including this one

Other organizations with this tax ID 37

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

View all 37

Locations

111 W High St
Ste 314
Elkton, MD 21921
Phone (410) 398-4510

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": "1711584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711584000000",
    "number": "1831940980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 NORTH ST",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219215512",
            "telephone_number": "410-398-3868",
            "fax_number": "410-620-3686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W HIGH ST STE 314",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219218617",
            "telephone_number": "410-620-0545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNION HOSPITAL OF CECIL COUNTY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-28",
        "last_updated": "2024-03-28",
        "certification_date": "2024-03-28",
        "status": "A",
        "authorized_official_last_name": "RIESEN",
        "authorized_official_first_name": "JUDY",
        "authorized_official_title_or_position": "CORPORATE DIRECTOR OF REVENUE CYCLE",
        "authorized_official_telephone_number": "302-623-7168"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Union Primary Care of Elkton",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elkton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2024; 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.