NPIMap

Organization Active NPI

University of Maryland Community Medical Group, Inc.

  • Family Medicine Physician
  • Queenstown, MD
National Provider Identifier
1851130967
Registry record updated May 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
UNIVERSITY OF MARYLAND COMMUNITY MEDICAL GROUP, INC.
Practice address
125 Shoreway Dr Ste 210
Queenstown, MD 21658-1682
Phone
(410) 770-5250
NPI assigned
May 20, 2024
Last updated
May 20, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
UNIVERSITY OF MARYLAND MEDICAL SYSTEM CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 20, 2024

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

Authorized official

Name
Paul Stephen Nicholson
Title
Senior Vice President - Chief Finan
Phone
(410) 337-1602

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

125 Shoreway Dr Ste 210
Queenstown, MD 21658-1682

Mailing address

900 Elkridge Landing Rd FL 2
Linthicum, MD 21090-2924

National Provider Directory

National Provider Directory
Tax ID family
University of Maryland Community Medical Group Inc176 organizations share this tax ID, including this one
Part of
University of Maryland Med Systems Corp - Harambee

Organizations with this tax ID in the same state 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1716163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716163200000",
    "number": "1851130967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 ELKRIDGE LANDING RD FL 2",
            "city": "LINTHICUM",
            "state": "MD",
            "postal_code": "210902924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 SHOREWAY DR STE 210",
            "city": "QUEENSTOWN",
            "state": "MD",
            "postal_code": "216581682",
            "telephone_number": "410-770-5250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY OF MARYLAND COMMUNITY MEDICAL GROUP, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UNIVERSITY OF MARYLAND MEDICAL SYSTEM CORPORATION",
        "enumeration_date": "2024-05-20",
        "last_updated": "2024-05-20",
        "certification_date": "2024-05-11",
        "status": "A",
        "authorized_official_last_name": "NICHOLSON",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "STEPHEN",
        "authorized_official_title_or_position": "SENIOR VICE PRESIDENT - CHIEF FINAN",
        "authorized_official_telephone_number": "410-337-1602"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Queenstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.