NPIMap

Organization Active NPI

Ideal Telemedicine Services, LLC

  • Clinic/Center
  • Waldorf, MD
National Provider Identifier
1881107282
Registry record updated Apr 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
IDEAL TELEMEDICINE SERVICES, LLC
Practice address
11355 Pembrooke SQ Ste 108
Waldorf, MD 20603-4805
Phone
(509) 222-1275
Fax
(509) 491-3031
NPI assigned
Nov 8, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2025

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

Authorized official

Name
Brian Jefferson Dawson
Title
Mco
Phone
(509) 222-1275

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

11355 Pembrooke SQ Ste 108
Waldorf, MD 20603-4805

Mailing address

500 SW 7TH St Ste A205
Renton, WA 98057-2983
Phone (877) 522-1275

National Provider Directory

National Provider Directory
Tax ID family
Ideal Telemedicine Serv LLC36 organizations share this tax ID, including this one

Other organizations with this tax ID 35

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

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1510099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744761600000",
    "number": "1881107282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 SW 7TH ST STE A205",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980572983",
            "telephone_number": "877-522-1275",
            "fax_number": "833-888-7145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11355 PEMBROOKE SQ STE 108",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206034805",
            "telephone_number": "509-222-1275",
            "fax_number": "509-491-3031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDEAL TELEMEDICINE SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-08",
        "last_updated": "2025-04-16",
        "certification_date": "2025-04-16",
        "status": "A",
        "authorized_official_last_name": "DAWSON",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "JEFFERSON",
        "authorized_official_title_or_position": "MCO",
        "authorized_official_telephone_number": "509-222-1275"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 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.