NPIMap

Organization Active NPI

East Coast Gastroenterology LLC

  • Gastroenterology Physician
  • Largo, MD
National Provider Identifier
1992998975
Registry record updated Dec 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
EAST COAST GASTROENTEROLOGY LLC
Practice address
1450 Mercantile LN
Suite 217
Largo, MD 20774-5376
Phone
(301) 583-7770
Fax
(301) 583-9414
NPI assigned
Aug 22, 2007
Last updated
Dec 5, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2008

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

Authorized official

Name
Michael Robert Nichols
Title
Credentialing Representative
Phone
(410) 258-6333

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0100X Primary
Clinical Pathology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207ZC0006X

Addresses

Primary practice location

1450 Mercantile LN
Suite 217
Largo, MD 20774-5376

Mailing address

PO Box 62249
Baltimore, MD 21264-2249
Phone (301) 583-7770

National Provider Directory

National Provider Directory

Locations

6134 Landover Rd
Cheverly, MD 20785
Phone (301) 341-1593

7700 Old Branch Ave
Ste 302
Clinton, MD 20735

9131 Piscataway Rd
Ste 610
Clinton, MD 20735
Phone (301) 868-2106

Practitioners & affiliated clinicians

Practitioners 8

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": "1187740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228435200000",
    "number": "1992998975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 62249",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212642249",
            "telephone_number": "301-583-7770",
            "fax_number": "301-583-9414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 MERCANTILE LN",
            "address_2": "SUITE 217",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207745376",
            "telephone_number": "301-583-7770",
            "fax_number": "301-583-9414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST COAST GASTROENTEROLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-22",
        "last_updated": "2008-12-05",
        "status": "A",
        "authorized_official_last_name": "NICHOLS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "CREDENTIALING REPRESENTATIVE",
        "authorized_official_telephone_number": "410-258-6333"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ZC0006X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pathology, Clinical Pathology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2008; 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.