NPIMap

Organization Active NPI

Fredericktown Ambulatory Surgical Facility, Inc.

  • Ambulatory Surgical Clinic/Center
  • Frederick, MD
National Provider Identifier
1972658706
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
A1166 Issued in MD
Legal business name
FREDERICKTOWN AMBULATORY SURGICAL FACILITY, INC.
Practice address
198 Thomas Johnson Dr
Suite 101
Frederick, MD 21702-4398
Phone
(301) 694-0870
Fax
(301) 694-7034
NPI assigned
Jan 24, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Vincent Edwin Difabio, D.D.S.NPI 1457406266
Title
Preseident
Phone
30169040870

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X A1166 MD Primary

Addresses

Primary practice location

198 Thomas Johnson Dr
Suite 101
Frederick, MD 21702-4398

Mailing address

198 Thomas Johnson Dr
Suite 101
Frederick, MD 21702-4398
Phone (301) 694-0870

National Provider Directory

National Provider Directory

Locations

198 Thomas Johnson Dr
#S101
Frederick, MD 21702
Phone (301) 694-0870

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1972658706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "198 THOMAS JOHNSON DR",
            "address_2": "SUITE 101",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024398",
            "telephone_number": "301-694-0870",
            "fax_number": "301-694-7034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "198 THOMAS JOHNSON DR",
            "address_2": "SUITE 101",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024398",
            "telephone_number": "301-694-0870",
            "fax_number": "301-694-7034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREDERICKTOWN AMBULATORY SURGICAL FACILITY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DIFABIO",
        "authorized_official_first_name": "VINCENT",
        "authorized_official_middle_name": "EDWIN",
        "authorized_official_title_or_position": "PRESEIDENT",
        "authorized_official_telephone_number": "30169040870",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "MD",
            "license": "A1166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.