NPIMap

Organization Active NPI

MD Matt LLC

  • Family Nurse Practitioner
  • Owings Mills, MD
National Provider Identifier
1962011288
Registry record updated Apr 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
MD MATT LLC
Practice address
10220 S Dolfield Rd Ste 106
Owings Mills, MD 21117-3660
Phone
(410) 575-1255
NPI assigned
Jul 23, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2023

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

Authorized official

Name
William Shaffer
Title
Director/Owner
Phone
(443) 559-4137

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

10220 S Dolfield Rd Ste 106
Owings Mills, MD 21117-3660

Mailing address

625 S Clinton St
Baltimore, MD 21224-4009
Phone (443) 559-4137

Other practice location 1

518 S Camp Meade Rd Ste 5
Linthicum, MD 21090-2766
Phone (443) 559-4137

Other practice location 2

7309 Baltimore Ave Ste 219
College Park, MD 20740-3200
Phone (443) 559-4137

Other practice location 3

309 E Patrick St
Frederick, MD 21701-6792
Phone (443) 559-4137

Other practice location 4

1050 North Point Rd Ste 203
Baltimore, MD 21224-3336
Phone (443) 559-4137

National Provider Directory

National Provider Directory
Tax ID family
MD Matt LLC10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1595462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680566400000",
    "number": "1962011288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 S CLINTON ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212244009",
            "telephone_number": "443-559-4137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10220 S DOLFIELD RD STE 106",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211173660",
            "telephone_number": "410-575-1255"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "518 S Camp Meade Rd Ste 5",
            "address_purpose": "LOCATION",
            "city": "Linthicum",
            "state": "MD",
            "postal_code": "210902766",
            "country_code": "US",
            "telephone_number": "443-559-4137",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7309 Baltimore Ave Ste 219",
            "address_purpose": "LOCATION",
            "city": "College Park",
            "state": "MD",
            "postal_code": "207403200",
            "country_code": "US",
            "telephone_number": "443-559-4137",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "309 E Patrick St",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217016792",
            "country_code": "US",
            "telephone_number": "443-559-4137",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1050 North Point Rd Ste 203",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212243336",
            "country_code": "US",
            "telephone_number": "443-559-4137",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MD MATT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-23",
        "last_updated": "2023-04-04",
        "certification_date": "2023-04-04",
        "status": "A",
        "authorized_official_last_name": "SHAFFER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "DIRECTOR/OWNER",
        "authorized_official_telephone_number": "443-559-4137"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Owings Mills, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 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.