NPIMap

Organization Active NPI

Specialty Physicians of Garrett County, LLC

  • Family Medicine Physician
  • Grantsville, MD
National Provider Identifier
1841002102
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SPECIALTY PHYSICIANS OF GARRETT COUNTY, LLC
Practice address
32 Corporate Dr
Grantsville, MD 21536-1259
Phone
(301) 895-8750
Fax
(301) 895-8751
NPI assigned
Jan 23, 2025
Organization subpart
Yes
Parent organization
SPECIALTY PHYSICIANS OF GARRETT COUNTY, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

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

Authorized official

Name
Lori Dixon
Title
Director, Finance
Phone
(301) 533-4251

Specialties & licenses 2

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

Addresses

Primary practice location

32 Corporate Dr
Grantsville, MD 21536-1259

Mailing address

PO Box 1647
Morgantown, WV 26507-1647

National Provider Directory

National Provider Directory
Tax ID family
Specialty Physicians of Garrett County LLC22 organizations share this tax ID, including this one
Part of
Specialty Physicians of Garrett County LLC

Other organizations with this tax ID 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1737590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737590400000",
    "number": "1841002102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1647",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265071647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 CORPORATE DR",
            "city": "GRANTSVILLE",
            "state": "MD",
            "postal_code": "215361259",
            "telephone_number": "301-895-8750",
            "fax_number": "301-895-8751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY PHYSICIANS OF GARRETT COUNTY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SPECIALTY PHYSICIANS OF GARRETT COUNTY, LLC",
        "enumeration_date": "2025-01-23",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A",
        "authorized_official_last_name": "DIXON",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "DIRECTOR, FINANCE",
        "authorized_official_telephone_number": "301-533-4251"
    },
    "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
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grantsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; 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.