CIVISTA CLINICAL SERVICES, L.L.C. (NPI# 1447450176) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447450176 |
| Entity Type | Organization |
| Organization Name | CIVISTA CLINICAL SERVICES, L.L.C. |
| Practice Address |
701 Charles St La Plata MD 20646-5930 |
| Mailing Address |
Po Box 1070 701 East Charles Street La Plata MD 20646-1070 |
| Practice Telephone | 3016094000 |
| Mailing Telephone | 3016094000 |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2007-07-20 |
| Authorized Official Name | GARY HERBEK (SVP COO) |
| Authorized Official Telephone | 3016094141 |
| Is Organization Subpart | Y |
| Parent Organization Name | CIVISTA CARE PARTNERS, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208M00000X | Hospitalist | Allopathic & Osteopathic Physicians |
| Street Address |
701 CHARLES ST |
| City | LA PLATA |
| State | MD |
| Zip Code | 20646-5930 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962402297 | Fernando Daniels IIi | Emergency Medicine | 701 Charles St, La Plata, MD 20646-5930 | 2005-07-28 |
| 1487100368 | Andre Foster | Nurse Practitioner | 701 Charles St, La Plata, MD 20646-5930 | 2016-08-30 |
| 1386797520 | Ann Marie Buckler | Nurse Anesthetist, Certified Registered | 701 Charles St, La Plata, MD 20646-5930 | 2007-01-19 |
| 1760535397 | Bronwyn Elizabeth Daugherty | Nurse Anesthetist, Certified Registered | 701 Charles St, La Plata, MD 20646-5930 | 2007-01-18 |
| 1730296401 | Danielle Telesford | Physician Assistant | 701 Charles St, La Plata, MD 20646-5930 | 2006-08-25 |
| 1407886781 | Capital Pain Management & Anesthesia Associates, LLC | Anesthesiology | 701 Charles St, Civista Medical Center, La Plata, MD 20646-5930 | 2006-07-03 |
| 1134178593 | Delphi Healthcare Partners of Maryland, LLC | Emergency Medicine | 701 Charles St, La Plata, MD 20646-5930 | 2006-05-10 |
| 1881643211 | Delphi Healthcare Partners of Maryland, LLC | Specialist | 701 Charles St, La Plata, MD 20646-5930 | 2006-05-10 |
| 1871542209 | Delphi Healthcare Partners of Maryland, LLC | Pediatrics | 701 Charles St, La Plata, MD 20646-5930 | 2006-05-10 |
| 1003865007 | Delphi Healthcare Partners of Maryland, LLC | Surgery | 701 Charles St, La Plata, MD 20646-5930 | 2006-05-08 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932718822 | Charles Regional Surgical Center LLC | Clinic/Center | 5 North Laplata Court, 2nd Floor, Laplata, MD 20646 | 2020-07-27 |
| 1902387988 | Sheldon Villarta | Physical Therapist | 10200 La Plata Town, La Plata, MD 20646 | 2018-08-27 |
| 1912485244 | Kelli Hill Goldsborough | Nurse Practitioner | 5 N La Plata Ct Ste 101, La Plata, MD 20646 | 2018-07-30 |
| 1083128490 | Charles County Rescue Squad Inc | Ambulance | 2 Calvert St, La Plata, MD 20646 | 2017-11-21 |
| 1801261532 | Catherine Deshetler | Social Worker | 5 N Maple Ave Ste 206, La Plata, MD 20646 | 2015-12-07 |
| 1215346481 | Brittany Godin | Speech-Language Pathologist | 5 Garrett Avenue, La Plata, MD 20646 | 2014-08-12 |
| 1558787606 | Homeplace Assisted Living | Assisted Living Facility | 10210 La Plata Rd, La Plata, MD 20646 | 2014-03-13 |
| 1891056628 | Godfrey T Hewitt | Dentist | 6620 Crain Hwy #204, Laplata, MD 20646 | 2012-06-07 |
| 1740573823 | Armida Bondoc Gonzales | Physical Therapist | 15 S Maple Ave, Apt 2, La Plata, MD 20646 | 2011-05-23 |
| 1023315348 | Charity E Dugan | Surgery | Um Charles Regional Medical Group, 5 North La Plata Court Ste 103, La Plata, MP 20646 | 2011-02-23 |
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| Taxonomy Code | 208M00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Hospitalist |
| Hospitalists are physicians whose primary professional focus is the general medical care of hospitalized patients. Their activities include patient care, teaching, research, and leadership related to Hospital Medicine. The term 'hospitalist' refers to physicians whose practice emphasizes providing care for hospitalized patients. |
| Notes: Source: American Society of Hospital Medicine, 2007. http://www.hospitalmedicine.org/ [7/1/2009: definition aded] Additional Resources: Hospitalist is a recognized fellowship specialty program offered by many medical institutions. There is no board certification for the specialty at this point. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225323496 | Mdics At Civista LLC | Hospitalist | 5 Garrett Ave, La Plata, MD 20646-5960 | 2011-06-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548618671 | Shore-bayy Hospitalists Associates | Hospitalist | 7651 Woodland Dr, Easton, MD 21601-8141 | 2016-05-31 |
| 1639525363 | Shivani Bassi | Hospitalist | 325 Hospital Dr Ste 108, Glen Burnie, MD 21061-5806 | 2016-05-12 |
| 1831564319 | Tsehaye Gesesew | Hospitalist | 6023 Turnabout Ln, Columbia, MD 21044-3058 | 2015-12-09 |
| 1316333719 | Nauroz Syed | Hospitalist | 345 St. Paul Place Mercy Medical Center, Bunting Building, 7th Floor, Baltimore, MD 21202 | 2015-04-13 |
| 1598150674 | Faisal Saeed | Hospitalist | 4940 Eastern Ave Fl Mflwest6, Baltimore, MD 21224-2735 | 2015-04-05 |
| 1548687809 | Howard County Hospitalists, LLC | Hospitalist | 10910 Little Patuxent Pkwy Ste 100, Columbia, MD 21044-3081 | 2014-03-25 |
| 1003251927 | Neal Bharat Shah | Hospitalist | 5200 Eastern Ave Fl Tower2, Baltimore, MD 21224-2734 | 2013-05-06 |
| 1679816532 | Elizabeth Eden | Hospitalist | 5200 Eastern Avene, Mfl East Tower 2nd Floor, Baltimore, MD 21224 | 2013-03-29 |
| 1649525965 | Sadiksha Adhikari | Hospitalist | 9208 Oswald Way, Apt 3c, Baltimore, MD 21237-4459 | 2012-07-24 |
| 1730434440 | Yahia Foda | Hospitalist | 6127 Landover Rd, Cheverly, MD 20785-1017 | 2012-07-18 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.