Clearway Surgery Center of Prince Frederick LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

CLEARWAY SURGERY CENTER OF PRINCE FREDERICK LLC

Practice address

110 Hospital Rd Ste 304
Prince Frederick, MD 20678-4046

Phone

(410) 571-2946

NPI assigned

Jul 28, 2020

Organization subpart

No

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

Authorized official

Name

Britni Cullen

Title

Sr. VP

Phone

(443) 837-9913

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Listed as

Clearway Surgery Center of Prince Frederick LLCCCN 21C0001639

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

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

{
    "created_epoch": "1595894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613520000000",
    "number": "1962011775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 DEFENSE HWY STE 205",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017096",
            "telephone_number": "410-571-2946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HOSPITAL RD STE 304",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206784046",
            "telephone_number": "410-571-2946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEARWAY SURGERY CENTER OF PRINCE FREDERICK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-28",
        "last_updated": "2021-02-17",
        "certification_date": "2021-02-17",
        "status": "A",
        "authorized_official_last_name": "CULLEN",
        "authorized_official_first_name": "BRITNI",
        "authorized_official_title_or_position": "SR. VP",
        "authorized_official_telephone_number": "443-837-9913"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Ambulatory Surgical Clinic/Center in Prince Frederick, MD
• Providers in Prince Frederick, MD by specialty
• Ambulatory Surgical Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2021; 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.