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Adventist Physician Services, Inc.

Organization Active NPI Clinic/Center · Clarksburg, MD

NPI 1972045805 · NPPES record last updated Nov 9, 2016

Key facts

NPI
1972045805
Entity type
Organization (NPI type 2)
Primary specialty
Clinic/Center 261Q00000X
Legal business name
ADVENTIST PHYSICIAN SERVICES, INC.
Practice address
22616 Gateway Center Dr
Suite E
Clarksburg, MD 20871-2011
Phone
(240) 826-8600
NPI assigned
Nov 9, 2016
Organization subpart
No

Authorized official

Name
James G Lee
Title
Cfo
Phone
(301) 315-3030

Corporate family (same tax ID) 12

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

National Provider Directory

Tax ID family
Adventist Physician Services PRBH (53 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Yes

Addresses

Primary practice location

22616 Gateway Center Dr
Suite E
Clarksburg, MD 20871-2011

Mailing address

820 W Diamond Ave
Suite 500
Gaithersburg, MD 20878-1419
Phone (301) 315-3102

Other names

  • Adventist Medical Group Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 9, 2016.

{
    "created_epoch": "1478649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478649600000",
    "number": "1972045805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 W DIAMOND AVE",
            "address_2": "SUITE 500",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208781419",
            "telephone_number": "301-315-3102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22616 GATEWAY CENTER DR",
            "address_2": "SUITE E",
            "city": "CLARKSBURG",
            "state": "MD",
            "postal_code": "208712011",
            "telephone_number": "240-826-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVENTIST PHYSICIAN SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-09",
        "last_updated": "2016-11-09",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "301-315-3030"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Adventist Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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