NPIMap

Organization Active NPI

Civista Partners Ambulatory Surgery Center

  • Ambulatory Surgical Clinic/Center
  • Waldorf, MD
National Provider Identifier
1902984321
Registry record updated Jul 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
A1303 Issued in MD
Legal business name
CIVISTA PARTNERS AMBULATORY SURGERY CENTER
Practice address
3510 Old Washington Rd
Suite 200
Waldorf, MD 20602-3233
Phone
(240) 427-1800
NPI assigned
Nov 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2008

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

Authorized official

Name
Mrs. Debra McClure
Title
Director of Clinical Operations
Phone
(240) 427-1807

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X A1303 MD Primary

Addresses

Primary practice location

3510 Old Washington Rd
Suite 200
Waldorf, MD 20602-3233

Mailing address

3510 Old Washington Rd
Suite 200
Waldorf, MD 20602-3233
Phone (240) 427-1800

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216771200000",
    "number": "1902984321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3510 OLD WASHINGTON RD",
            "address_2": "SUITE 200",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023233",
            "telephone_number": "240-427-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3510 OLD WASHINGTON RD",
            "address_2": "SUITE 200",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023233",
            "telephone_number": "240-427-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CIVISTA PARTNERS AMBULATORY SURGERY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2008-07-23",
        "status": "A",
        "authorized_official_last_name": "MCCLURE",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "DIRECTOR OF CLINICAL OPERATIONS",
        "authorized_official_telephone_number": "240-427-1807",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MD",
            "license": "A1303",
            "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 Jul 23, 2008; 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.