NPIMap

Organization Active NPI

Eastern Shore Surgery Center LLC

  • Multi-Specialty Clinic/Center
  • Easton, MD
National Provider Identifier
1891766283
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
EASTERN SHORE SURGERY CENTER LLC
Practice address
6 Caulk LN
Easton, MD 21601-3854
Phone
(410) 822-5552
Fax
(410) 822-8238
NPI assigned
Feb 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
John P Knud Hansen, MD
Title
Authorized Official Vice President
Phone
(410) 822-5552

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

6 Caulk LN
Easton, MD 21601-3854

Mailing address

6 Caulk LN
Easton, MD 21601-3854
Phone (410) 822-5552

National Provider Directory

National Provider Directory
Tax ID family
Eastern Shore Lithotripsy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

6 Caulk Ln
Easton, MD 21601
Phone (410) 822-5552

NPI Registry JSON

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

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891766283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 CAULK LN",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216013854",
            "telephone_number": "410-822-5552",
            "fax_number": "410-822-8238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 CAULK LN",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216013854",
            "telephone_number": "410-822-5552",
            "fax_number": "410-822-8238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN SHORE SURGERY CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KNUD HANSEN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL VICE PRESIDENT",
        "authorized_official_telephone_number": "410-822-5552",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Easton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.