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
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

4000 Mitchellville Rd
Ste B430
Bowie, MD 20716
Phone (240) 334-2300

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

7700 Old Branch Ave
Ste 302
Clinton, MD 20735

101 Centennial St
Ste B
La Plata, MD 20646
Phone (301) 870-3171

1450 Mercantile Ln
Upper Marlboro, MD 20774
Phone (301) 386-5453

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

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.