Active NPI
Primedoc of Frederick PA
- Internal Medicine Physician
- Frederick, MD
National Provider Identifier
1952367476
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- PRIMEDOC OF FREDERICK PA
- Practice address
- 400 W Seventh St
Frederick, MD 21701-4506 - Phone
- (843) 237-3378
- Fax
- (843) 237-5073
- NPI assigned
- Apr 24, 2006
- Last updated
- Mar 16, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Robert Reynolds, MD
- Title
- President
- Phone
- (828) 210-3260
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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | Primary |
Addresses
Primary practice location
400 W Seventh St
Frederick, MD 21701-4506
Mailing address
PO Box 601360
Charlotte, NC 28260-1360
Phone (843) 237-3378
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 136915 | Other | VA | BCBS |
| 633APR | Other | MD | BLUE SHIELD STATE |
| 404823700 | Medicaid | MD | |
| J585 | Other | MD | BLUE SHIELD FEDERAL |
| DB5153 | Other | MD | RAILROAD MEDICARE |
National Provider Directory
National Provider DirectoryPractitioners & 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.
-
- Internal Medicine Physician
- Albemarle, NC
- NPI 1861453383
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145836800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1237161600000",
"number": "1952367476",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 601360",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282601360",
"telephone_number": "843-237-3378",
"fax_number": "843-237-5073"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 W SEVENTH ST",
"city": "FREDERICK",
"state": "MD",
"postal_code": "217014506",
"telephone_number": "843-237-3378",
"fax_number": "843-237-5073"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PRIMEDOC OF FREDERICK PA",
"organizational_subpart": "NO",
"enumeration_date": "2006-04-24",
"last_updated": "2009-03-16",
"status": "A",
"authorized_official_last_name": "REYNOLDS",
"authorized_official_first_name": "ROBERT",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "828-210-3260",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "136915",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD STATE",
"identifier": "633APR",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "404823700",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD FEDERAL",
"identifier": "J585",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "DB5153",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Frederick, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.