NPIMap

Organization Active NPI

Maryland Spine Center Chartered

  • Orthopaedic Surgery of the Spine Physician
  • Baltimore, MD
National Provider Identifier
1952418535
Registry record updated Jul 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery of the Spine PhysicianTaxonomy code 207XS0117X
Legal business name
MARYLAND SPINE CENTER CHARTERED
Practice address
301 St Paul Place
Spine Center, Lower Level
Baltimore, MD 21202
Phone
(410) 539-3434
Fax
(410) 366-2202
NPI assigned
Aug 23, 2006
Last updated
Jul 2, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2013

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

Authorized official

Name
Charles Edwards, IINPI 1568572030
Title
Title
Phone
(410) 659-2802

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X
Orthopaedic Surgery of the Spine Physician 207XS0117X Primary

Addresses

Primary practice location

301 St Paul Place
Spine Center, Lower Level
Baltimore, MD 21202

Mailing address

PO Box 418375
Boston, MA 02241-8375

Other identifiers 3

IdentifierTypeStateIssuer
LZ51OtherBC / BS OF MD
374002100MedicaidMD
F 482OtherMDBLUE CHOICE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040325000144 MD Part B Supplier - Clinic/Group Practice 0446142673 Receives reassigned benefits from 25 practitioners
Practice locations: Lutherville, MD; Reisterstown, MD; Glen Burnie, MD; Baltimore, MD

National Provider Directory

National Provider Directory

Locations

301 Saint Paul St
#225
Baltimore, MD 21202

Practitioners & affiliated clinicians

Practitioners 28

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.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372723200000",
    "number": "1952418535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 418375",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022418375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 ST PAUL PLACE",
            "address_2": "SPINE CENTER, LOWER LEVEL",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21202",
            "telephone_number": "410-539-3434",
            "fax_number": "410-366-2202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND SPINE CENTER CHARTERED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-23",
        "last_updated": "2013-07-02",
        "status": "A",
        "authorized_official_last_name": "EDWARDS, II",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "TITLE",
        "authorized_official_telephone_number": "410-659-2802"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC / BS OF MD",
            "identifier": "LZ51",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "374002100",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "F 482",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2013; 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.