Mid-Atlantic of Fairfield, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

02008 Issued in MD

Legal business name

MID-ATLANTIC OF FAIRFIELD, LLC

Practice address

1454 Fairfield Loop Rd
Crownsville, MD 21032-2006

Phone

(410) 923-6820

Fax

(410) 923-2416

NPI assigned

Feb 8, 2017

Organization subpart

No

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

Authorized official

Name

Barbara McAdams

Title

Director of Ar

Phone

(410) 923-2415

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1486512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486512000000",
    "number": "1922546142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1454 FAIRFIELD LOOP RD",
            "city": "CROWNSVILLE",
            "state": "MD",
            "postal_code": "210322006",
            "telephone_number": "410-923-6820",
            "fax_number": "410-923-2416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1454 FAIRFIELD LOOP RD",
            "city": "CROWNSVILLE",
            "state": "MD",
            "postal_code": "210322006",
            "telephone_number": "410-923-6820",
            "fax_number": "410-923-2416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-ATLANTIC OF FAIRFIELD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-08",
        "last_updated": "2017-02-08",
        "status": "A",
        "authorized_official_last_name": "MCADAMS",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_title_or_position": "DIRECTOR OF AR",
        "authorized_official_telephone_number": "410-923-2415"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "MD",
            "license": "02008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "556234100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Lisa Merson
• Mid-Atlantic of Fairfield, LLC
• Bailey Ann Morgan, FNP-C
• Kesi Japera Motley-Shannon, LGSW
• MWB Associates LLC
• Nancee Ann Baysinger Ann Nancee Ann Baysinger, LAC.
• Seamus Nash, BS; CSC-AD

• All providers in Crownsville, MD
• Skilled Nursing Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2017; 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.