SHADY GROVE AMBULATORY SURGERY CENTER,LLC (NPI# 1558463257) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558463257 |
| Entity Type | Organization |
| Organization Name | SHADY GROVE AMBULATORY SURGERY CENTER,LLC |
| Practice Address |
16220 S Frederick Ave Suite 427 Gaithersburg MD 20877-4039 |
| Practice Telephone | 3019482995 |
| Practice Fax Number | 3019486056 |
| Mailing Telephone | 3019482995 |
| Mailing Fax Number | 3019486056 |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2009-08-25 |
| Authorized Official Name | RONALD ALLEN FOOTER (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 3019482995 |
| Authorized Official Credential | D.P.M. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
A1135 | MD | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | MARYLAND STATE LICENSE # | A1135 | 01 |
| Street Address |
16220 S FREDERICK AVE SUITE 427 |
| City | GAITHERSBURG |
| State | MD |
| Zip Code | 20877-4039 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811991144 | Frank J Mayo | Internal Medicine | 16220 S Frederick Ave, Ste 213, Gaithersburg, MD 20877-4017 | 2005-06-02 |
| 1356691422 | Adriana De Palma | Social Worker | 16220 S Frederick Ave, Suite 502, Gaithersburg, MD 20877 | 2012-09-14 |
| 1679774020 | Lisa Barban Curwin | Psychologist | 16220 S Frederick Ave, Suite 308, Gaithersburg, MD 20877-4039 | 2007-05-31 |
| 1881807709 | Eddie H Lam | Dentist | 16220 S Frederick Ave, Suite 505, Gaithersburg, MD 20877-4039 | 2007-05-07 |
| 1518083443 | Shady Grove Podiatry, LLC | Podiatrist | 16220 S Frederick Ave, Suite 427, Gaithersburg, MD 20877-4039 | 2007-03-22 |
| 1215061759 | Comprehensive Dermatology Center, P.c | Dermatology | 16220 S Frederick Ave, Suite 420, Gaithersburg, MD 20877-4039 | 2007-03-15 |
| 1093859720 | Shady Grove Podiatry LLC | Durable Medical Equipment & Medical Supplies | 16220 S Frederick Ave, Suite 200, Gaithersburg, MD 20877-4039 | 2007-02-16 |
| 1205979614 | Laura Ting | Social Worker | 16220 S Frederick Ave, Suite 502, Gaithersburg, MD 20877-4039 | 2007-02-15 |
| 1336288208 | Peggy Dienes | Social Worker | 16220 S Frederick Ave, Suite 502, Gaithersburg, MD 20877-4039 | 2007-02-06 |
| 1821152497 | Adele Redisch | Social Worker | 16220 S Frederick Ave, Suite 512, Gaithersburg, MD 20877-4039 | 2006-12-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083182083 | Elizabeth Schuman | Physical Therapist | 8100 Midcounty Highway, Gaithersburg, MD 20877 | 2018-11-07 |
| 1528544970 | Stephanie Lucas | Behavior Technician | 17755 Larchmont Ter, Gaithersburg, MD 20877 | 2018-07-18 |
| 1508351370 | National Vision, Inc. | Technician/Technologist | 18304 Contour Road, Montgomery Village, MD 20877 | 2018-06-25 |
| 1912496993 | Elias Kamal Abdi | Dentist | 200 Girard Street, #106, Gaithersburg, MD 20877 | 2018-05-06 |
| 1942741947 | Emily Katherine Griffin | Counselor | 501 N Frederick Ave Ste 300, Gaithersburg, MD 20877 | 2017-03-10 |
| 1285004317 | Institute for Family Centered Services | Community/Behavioral Health | 1600 S Frederick Ave, Suite 312, Gaithersburg, MD 20877 | 2015-10-01 |
| 1083097893 | Sylwia Patrycja Fowler | Psychiatry & Neurology | 604 S Frederick Ave Ste 211, Gaithersburg, MD 20877 | 2015-06-30 |
| 1962896126 | Estefania Ospina | Social Worker | 16220 Frederick Rd., Suite 310, Gaithersburg, MD 20877 | 2015-03-26 |
| 1619306206 | Patricia Elizabeth Deleon | Registered Nurse | 702 Russell Ave., #100, Gaithersburg, MD 20877 | 2013-11-05 |
| 1669805719 | International Pediatrics Pa | Pediatrics | 501 North Fredrick Ave Ste 212, Gaithersburg, MD 20877 | 2013-08-13 |
| Find all providers in zip 20877 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477745883 | Quince Orchard Surgery Center, LLC | Clinic/Center | 900 Wind River Lane, Suite 106, Gaithersburg, MD 20878 | 2007-08-10 |
| 1497023188 | Kaiser Foundation Health Plan of The Mid-atlantic States, Inc. | Clinic/Center | 655 Watkins Mill Rd, Gaithersburg, MD 20879-3323 | 2011-12-08 |
| 1447442876 | Maple Spring Podiatric Surgical Center, Inc | Clinic/Center | 10810 Darnestown Rd, #101, Gaithersburg, MD 20878-2675 | 2007-08-09 |
| 1760507834 | Gaithersburg Foot and Ankle Surgery Center | Clinic/Center | 60 Market St, Suite #202, Gaithersburg, MD 20878-6548 | 2007-03-20 |
| 1487779435 | Lakeforest Ambulatory Surgery Center | Clinic/Center | 702 Russell Ave, #301, Gaithersburg, MD 20877-2606 | 2007-03-20 |
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|---|---|---|---|---|
| 1942807961 | Vascular Surgery Center of Abingdon | Clinic/Center | 3435 Box Hill Corporate Center Dr Ste H, Abingdon, MD 21009-1204 | 2020-10-02 |
| 1518570084 | Eastside Anesthesia LLC | Clinic/Center | 19 Fontana Ln Ste 104, Rosedale, MD 21237-3027 | 2020-08-25 |
| 1215548524 | Summit Ambulatory Surgical Center, LLC | Clinic/Center | 800 Bestgate Rd Ste 200, Annapolis, MD 21401-3016 | 2020-08-11 |
| 1861001372 | Bay Surgery Centers LLC | Clinic/Center | 810 Bestgate Rd Ste 120, Annapolis, MD 21401-3033 | 2020-07-30 |
| 1417566217 | Clearway Surgery Center of Easton, LLC | Clinic/Center | 598 Cynwood Dr Ste 103, Easton, MD 21601-3875 | 2020-07-28 |
| 1932718822 | Charles Regional Surgical Center LLC | Clinic/Center | 5 North Laplata Court, 2nd Floor, Laplata, MD 20646 | 2020-07-27 |
| 1528680865 | Meridian Surgery Center LLC | Clinic/Center | 19638 Leitersburg Pike Ste 205, Hagerstown, MD 21742-1515 | 2020-05-09 |
| 1346862869 | Nspc Surgery Center of Maryland, LLC | Clinic/Center | 6710 Oxon Hill Rd Ste 550b, Oxon Hill, MD 20745-1117 | 2020-05-07 |
| 1225665292 | Annapolis Endoscopy Center LLC | Clinic/Center | 1419 Forest Dr Ste 105, Annapolis, MD 21403-1474 | 2020-03-26 |
| 1992345748 | Podiatry Associates Ambulatory Surgical Centers LLC | Clinic/Center | 9105 Franklin Square Dr Ste 206, Baltimore, MD 21237-3954 | 2020-01-09 |
| Find all providers with the same taxonomy | ||||
| City | GAITHERSBURG |
| Zip Code | 20877 |
Please comment or provide details below to improve the information on SHADY GROVE AMBULATORY SURGERY CENTER,LLC.
| 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.