Individual provider Active NPI

Joseph Henry Avery,III, M.D.

  • Internal Medicine Physician
  • Clinton, MD
National Provider Identifier
1841301769
Registry record updated Dec 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0034671 Issued in MD
Practice address
10403 Hospital Dr
Suite 103
Clinton, MD 20735-3134
Phone
(301) 877-4210
Fax
(301) 856-8994
NPI assigned
Aug 31, 2006
Last updated
Dec 20, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0034671 MD Primary

Addresses

Primary practice location

10403 Hospital Dr
Suite 103
Clinton, MD 20735-3134

Mailing address

10403 Hospital Dr
Suite 103
Clinton, MD 20735-3134
Phone (301) 877-4210

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080904000132 DC Practitioner - Internal Medicine 1951477686

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0034671MDMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482192000000",
    "number": "1841301769",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10403 HOSPITAL DR",
            "address_2": "SUITE 103",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207353134",
            "telephone_number": "301-877-4210",
            "fax_number": "301-856-8994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10403 HOSPITAL DR",
            "address_2": "SUITE 103",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207353134",
            "telephone_number": "301-877-4210",
            "fax_number": "301-856-8994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVERY,III",
        "first_name": "JOSEPH",
        "middle_name": "HENRY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2016-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0034671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, MD

Sources for this page

Verify at the official NPI Registry.