NPIMap

Organization Active NPI

Ally Infusion, LLC

Doing business as Charles County Neurology

  • Neurology Physician
  • Waldorf, MD
National Provider Identifier
1942982988
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
ALLY INFUSION, LLC
Doing business as
Charles County Neurology
Practice address
11637 Terrace Dr Ste 100
Waldorf, MD 20602-3707
Phone
(301) 870-7287
NPI assigned
Aug 1, 2023
Last updated
Aug 1, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
ALLY INFUSION, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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

Authorized official

Name
Roche Watson, CRNPNPI 1639522659
Title
Practice Owner
Phone
(301) 870-7287

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X NU Primary
Family Nurse Practitioner 363LF0000X NU

Addresses

Primary practice location

11637 Terrace Dr Ste 100
Waldorf, MD 20602-3707

Mailing address

11637 Terrace Dr Ste 100
Waldorf, MD 20602-3707
Phone (301) 870-7287

Other names 1

  • Charles County Neurology Doing business as

National Provider Directory

National Provider Directory
Part of
Ally Infusion LLC

Locations

11637 Terrace Dr
Ste 100
Waldorf, MD 20602
Phone (301) 870-7287

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1690848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690848000000",
    "number": "1942982988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11637 TERRACE DR STE 100",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023707",
            "telephone_number": "301-870-7287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11637 TERRACE DR STE 100",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206023707",
            "telephone_number": "301-870-7287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLY INFUSION, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ALLY INFUSION, LLC",
        "enumeration_date": "2023-08-01",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A",
        "authorized_official_last_name": "WATSON",
        "authorized_official_first_name": "ROCHE",
        "authorized_official_title_or_position": "PRACTICE OWNER",
        "authorized_official_telephone_number": "301-870-7287",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Charles County Neurology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 1, 2023; 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.