NPIMap

Organization Active NPI

M Medical Group, Inc.

  • Internal Medicine Physician
  • Laurel, MD
National Provider Identifier
1841006038
Registry record updated Dec 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
M MEDICAL GROUP, INC.
Practice address
14200 Laurel Park Dr
Laurel, MD 20707-5201
Phone
(410) 792-4717
NPI assigned
Dec 4, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2024

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

Authorized official

Name
Krystle D Brown
Title
Billing Manager
Phone
(410) 800-6251

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

14200 Laurel Park Dr
Laurel, MD 20707-5201

Mailing address

14200 Laurel Park Dr
Laurel, MD 20707-5201
Phone (410) 792-4717

Other names 1

  • Autumn Lake Patuxent River Health and Rehab Other name

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
21D0671593Patuxent River Health & Rehab14200 Laurel Park Drive, Laurel, MD 20707Certificate of waiverAug 8, 2026

National Provider Directory

National Provider Directory
Tax ID family
M Medical Group Inc61 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 21

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 21

Practitioners & affiliated clinicians

Practitioners 1

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": "1733270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1733270400000",
    "number": "1841006038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14200 LAUREL PARK DR",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075201",
            "telephone_number": "410-792-4717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14200 LAUREL PARK DR",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207075201",
            "telephone_number": "410-792-4717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-12-04",
        "last_updated": "2024-12-04",
        "certification_date": "2024-12-03",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "KRYSTLE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "410-800-6251"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Autumn Lake Patuxent River Health and Rehab",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Laurel, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.