Organization Active NPI

Ophthalmology Associates of Greater Annapolis PA

  • Ophthalmology Physician
  • Arnold, MD
National Provider Identifier
1952489064
Registry record updated Oct 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
D0013809 Issued in MD
Legal business name
OPHTHALMOLOGY ASSOCIATES OF GREATER ANNAPOLIS PA
Practice address
83 Church Rd
Arnold, MD 21012-2306
Phone
(410) 757-2778
Fax
(410) 757-0632
NPI assigned
Nov 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2010

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

Authorized official

Name
Ms. Charlene R Bryant, C.O.T.
Title
Ophthalmic Technician
Phone
(410) 757-2778

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207W00000X D0013809 MD Primary
Eyewear Supplier 332H00000X

Addresses

Primary practice location

83 Church Rd
Arnold, MD 21012-2306

Mailing address

83 Church Rd
Arnold, MD 21012-2306
Phone (410) 757-2778

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101103001297 MD Part B Supplier - Clinic/Group Practice 3678692928 Receives reassigned benefits from 4 practitioners
Practice locations: Arnold, MD

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D2096493Ophthalmology Associates of Greater Annapolis83 Church Road, Arnold, MD 21012Certificate of waiverMay 26, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1286928000000",
    "number": "1952489064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 CHURCH RD",
            "city": "ARNOLD",
            "state": "MD",
            "postal_code": "210122306",
            "telephone_number": "410-757-2778",
            "fax_number": "410-757-0632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 CHURCH RD",
            "city": "ARNOLD",
            "state": "MD",
            "postal_code": "210122306",
            "telephone_number": "410-757-2778",
            "fax_number": "410-757-0632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPHTHALMOLOGY ASSOCIATES OF GREATER ANNAPOLIS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2010-10-13",
        "status": "A",
        "authorized_official_last_name": "BRYANT",
        "authorized_official_first_name": "CHARLENE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OPHTHALMIC TECHNICIAN",
        "authorized_official_telephone_number": "410-757-2778",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "C.O.T."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "MD",
            "license": "D0013809",
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arnold, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.