NPIMap

Organization Active NPI

Meritus Medical Center Inc

  • Psychiatry Physician
  • Hagerstown, MD
National Provider Identifier
1962234716
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
MERITUS MEDICAL CENTER INC
Practice address
13121 Brooklane Dr
Hagerstown, MD 21742-1514
Phone
(301) 733-0330
NPI assigned
Aug 19, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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

Authorized official

Name
Joshua Repac
Title
Cfo
Phone
(301) 790-9351

Specialties & licenses 9

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X
Professional CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YP2500X
School CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YS0200X
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
School Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041S0200X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

13121 Brooklane Dr
Hagerstown, MD 21742-1514

Mailing address

11116 Medical Campus Rd
Hagerstown, MD 21742-6710

Other practice location 1

4540 Mack Ave Ste B
Frederick, MD 21703-3303
Phone (301) 733-0330

Other practice location 2

5301 Buckeystown Pike
Frederick, MD 21704-8370
Phone (301) 733-0330

Other practice location 3

13310-A Brook Lane
Laurel Hall
Hagerstown, MD 21742
Phone (301) 733-0330

Other practice location 4

13218 Brook Lane
Stonebridge
Hagerstown, MD 21742
Phone (301) 733-0330

Other practice location 5

18714 N Village
Hagerstown, MD 21742-2454
Phone (301) 733-0330

Other practice location 6

1050 W Industrial Blvd
Cumberland, MD 21502-4331
Phone (301) 733-0330

National Provider Directory

National Provider Directory
Tax ID family
Washngton Co Hos Ass-Su40 organizations share this tax ID, including this one

Other organizations with this tax ID 39

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

View all 39

NPI Registry JSON

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

{
    "created_epoch": "1724025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724025600000",
    "number": "1962234716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11116 MEDICAL CAMPUS RD",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217426710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13121 BROOKLANE DR",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217421514",
            "telephone_number": "301-733-0330"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4540 Mack Ave Ste B",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217033303",
            "country_code": "US",
            "telephone_number": "301-733-0330",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5301 Buckeystown Pike",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217048370",
            "country_code": "US",
            "telephone_number": "301-733-0330",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13310-A Brook Lane",
            "address_2": "Laurel Hall",
            "address_purpose": "LOCATION",
            "city": "Hagerstown",
            "state": "MD",
            "postal_code": "21742",
            "country_code": "US",
            "telephone_number": "301-733-0330",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13218 Brook Lane",
            "address_2": "Stonebridge",
            "address_purpose": "LOCATION",
            "city": "Hagerstown",
            "state": "MD",
            "postal_code": "21742",
            "country_code": "US",
            "telephone_number": "301-733-0330",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18714 N Village",
            "address_purpose": "LOCATION",
            "city": "Hagerstown",
            "state": "MD",
            "postal_code": "217422454",
            "country_code": "US",
            "telephone_number": "301-733-0330",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1050 W Industrial Blvd",
            "address_purpose": "LOCATION",
            "city": "Cumberland",
            "state": "MD",
            "postal_code": "215024331",
            "country_code": "US",
            "telephone_number": "301-733-0330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MERITUS MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-19",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-15",
        "status": "A",
        "authorized_official_last_name": "REPAC",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "301-790-9351"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YS0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, School",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; 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.