Linda M. Jefferson, MD PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

D0054004 Issued in MD

Legal business name

LINDA M. JEFFERSON, MD PA

Practice address

2670 Crain Hwy
Suite 410
Waldorf, MD 20601-2806

Phone

(301) 374-9300

Fax

(301) 374-9469

NPI assigned

Oct 1, 2007

Organization subpart

No

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

Authorized official

Name

Linda M Jefferson, MDNPI 1164415832

Title

Ceo

Phone

(301) 374-9300

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Locations

Practitioners 1

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

• Linda Jefferson, MD

  • Internal Medicine Physician
  • Waldorf, MD
  • NPI 1164415832
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466553600000",
    "number": "1922295237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2670 CRAIN HWY",
            "address_2": "SUITE 410",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206012806",
            "telephone_number": "301-374-9300",
            "fax_number": "301-374-9469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2670 CRAIN HWY",
            "address_2": "SUITE 410",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206012806",
            "telephone_number": "301-374-9300",
            "fax_number": "301-374-9469"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINDA M. JEFFERSON, MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-01",
        "last_updated": "2016-06-22",
        "status": "A",
        "authorized_official_last_name": "JEFFERSON",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "301-374-9300",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0054004",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "332602100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Waldorf, MD
• Providers in Waldorf, MD by specialty
• Family Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.