NPIMap

Organization Active NPI

Medical & Surgical Clinics of Southern Maryland Inc

  • Family Medicine Physician
  • Clinton, MD
National Provider Identifier
1851473722
Registry record updated Feb 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MEDICAL & SURGICAL CLINICS OF SOUTHERN MARYLAND INC
Practice address
10403 Hospital Drive
Suite G-04
Clinton, MD 20735-3134
Phone
(301) 856-3019
Fax
(301) 856-9370
NPI assigned
Oct 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2011

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

Authorized official

Name
Jane Raymond
Title
Vice President
Phone
(301) 856-3019

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X
Otolaryngology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Y00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X

Addresses

Primary practice location

10403 Hospital Drive
Suite G-04
Clinton, MD 20735-3134

Mailing address

10403 Hospital Drive
Suite G-04
Clinton, MD 20735-3134
Phone (301) 856-3019

Other identifiers 1

IdentifierTypeStateIssuer
222101200MedicaidMD

National Provider Directory

National Provider Directory

Locations

10 Saint Patricks Dr
#203
Waldorf, MD 20603
Phone (301) 396-8071

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 35

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1298246400000",
    "number": "1851473722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10403 HOSPITAL DRIVE",
            "address_2": "SUITE G-04",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207353134",
            "telephone_number": "301-856-3019",
            "fax_number": "301-856-9370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10403 HOSPITAL DRIVE",
            "address_2": "SUITE G-04",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207353134",
            "telephone_number": "301-856-3019",
            "fax_number": "301-856-9370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL & SURGICAL CLINICS OF SOUTHERN MARYLAND INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2011-02-21",
        "status": "A",
        "authorized_official_last_name": "RAYMOND",
        "authorized_official_first_name": "JANE",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "301-856-3019"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "222101200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2011; 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.