CALVERTHEALTH MEDICAL CENTER, INC. (NPI# 1558718668) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1558718668 |
Entity Type | Organization |
Organization Name | CALVERTHEALTH MEDICAL CENTER, INC. |
Other Organization Name | CALVERTHEALTH OUTPATIENT REHABILITATION PRINCE FREDERICK |
Practice Address |
130 Hospital Rd Suite 103 Prince Frederick MD 20678-4015 |
Mailing Address |
100 Hospital Rd Att: Contract & Credentialing Prince Frederick MD 20678-4017 |
Practice Telephone | 4105358180 |
Practice Fax Number | 4105358325 |
Mailing Telephone | 4104144791 |
Mailing Fax Number | 4104144558 |
Enumeration Date | 2016-05-18 |
Last Update Date | 2018-01-24 |
Authorized Official Name | DEAN TEAGUE (PRESIDENT/CEO) |
Authorized Official Telephone | 4105358239 |
Is Organization Subpart | Y |
Parent Organization Name | CALVERT HEALTH SYSTEM, INC. |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 224Z00000X | Occupational Therapy Assistant | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
N | 225100000X | Physical Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
N | 225200000X | Physical Therapy Assistant | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
N | 225X00000X | Occupational Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MD | 728804202 | 05 |
Other Name | Type Code |
---|---|
CalvertHealth Outpatient Rehabilitation Prince Frederick | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1942657051 | Calverthealth Medical Center, Inc. | Occupational Therapy Assistant | 14090 Hg Trueman Rd, Suite 1500, Solomons, MD 20688-3151 | 2016-05-18 |
1578910683 | Calverthealth Medical Center, Inc. | Occupational Therapy Assistant | 10845 Town Center Blvd, Suite 100, Dunkirk, MD 20754-2712 | 2016-05-18 |
1598195299 | Calverthealth Medical Center, Inc. | Clinic/Center | 130 Hospital Rd, Suite 102, Prince Frederick, MD 20678-4015 | 2013-11-15 |
1407283302 | Calverthealth Medical Center, Inc. | Clinic/Center | 85 Hospital Rd, Prince Frederick, MD 20678-4018 | 2013-10-09 |
1588808935 | Calverthealth Medical Center, Inc. | Clinic/Center | 14090 Hg Trueman Rd, Ste 1400, Solomons, MD 20688-3151 | 2009-04-29 |
1659550994 | Calverthealth Medical Center, Inc. | Clinic/Center | 29449 Charlotte Hall Rd, Charlotte Hall, MD 20622-3042 | 2007-11-02 |
1245387208 | Calverthealth Medical Center, Inc. | Clinic/Center | 14090 Hg Trueman Rd, Suite1300, Solomons, MD 20688-3151 | 2007-01-04 |
1578620779 | Calverthealth Medical Center, Inc. | Clinic/Center | 10845 Town Center Blvd, Suite 108, Dunkirk, MD 20754-2712 | 2007-01-03 |
1457389298 | Calverthealth Medical Center, Inc. | General Acute Care Hospital | 100 Hospital Rd, Prince Frederick, MD 20678-4017 | 2006-06-29 |
Street Address |
130 HOSPITAL RD SUITE 103 |
City | PRINCE FREDERICK |
State | MD |
Zip Code | 20678-4015 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1073598462 | Lacy Twining Pitman | Nurse Practitioner | 130 Hospital Rd, Suite 201, Prince Frederick, MD 20678-4015 | 2005-12-08 |
1992247589 | Gabriella Marie Reed | Registered Nurse | 130 Hospital Rd, Prince Frederick, MD 20678-4015 | 2016-11-14 |
1154701464 | Laboratory Corporation of America | Clinical Medical Laboratory | 130 Hospital Rd, Suite 101, Prince Frederick, MD 20678-4015 | 2015-06-02 |
1598195299 | Calverthealth Medical Center, Inc. | Clinic/Center | 130 Hospital Rd, Suite 102, Prince Frederick, MD 20678-4015 | 2013-11-15 |
1326382409 | Ryan A Hunsicker | Physical Therapist | 130 Hospital Rd, Suite 103, Prince Frederick, MD 20678-4015 | 2012-11-15 |
1225310477 | Mcdermott Chiropractic Care, P.C. | Clinic/Center | 130 Hospital Rd, Suite 103, Prince Frederick, MD 20678-4015 | 2011-09-14 |
1811292162 | Amanda E Eller | Physical Therapist | 130 Hospital Rd, Suite 103, Prince Frederick, MD 20678-4015 | 2011-01-18 |
1992007645 | Christine Marie Berube | Occupational Therapist | 130 Hospital Rd, Suite 130, Prince Frederick, MD 20678-4015 | 2010-12-01 |
1477871507 | Christine Fratantuono | Physical Therapist | 130 Hospital Rd, Suite 103, Prince Frederick, MD 20678-4015 | 2010-05-13 |
1417285784 | Amy Elizabeth Larson | Physician Assistant | 130 Hospital Rd, Suite 101, Prince Frederick, MD 20678-4015 | 2009-11-25 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1861857500 | Watershed Counseling Service | Counselor | 246 Merrimac Court, Prince Frederick, MD 20678 | 2015-12-23 |
1023449642 | Mary Gordon Walter | Registered Nurse | 976 Solomans Island Road, Prince Frederick, MD 20678 | 2013-12-07 |
1891126827 | Jacqueline Leclercq | Nurse Practitioner | 110 Hospital Road Suite 303, Prince Frederick, MD 20678 | 2013-12-02 |
1174959001 | Linsey Rowe Heane | Physical Therapist | 110 Main Street Suite 1, Prince Frederick, MD 20678 | 2013-09-24 |
1053607002 | Tidewater Dental Pf | Dentist | 690 Prince Frederick Blvd, Prince Frederick, MD 20678 | 2011-06-28 |
1033411558 | Sharon Patricia Parran | Pharmacist | 80 W.dares Beach Road, Prince Frederick, MD 20678 | 2010-12-04 |
1366684326 | Prince Frederick Surgery Center LLC | Clinic/Center | 70 Sherry Lane, Suite 101, Prince Frederick, MD 20678 | 2009-04-06 |
1982844734 | Orthocare Solutions Inc | Durable Medical Equipment & Medical Supplies | 220 Old Solomans Island Rd, Prince Frederick, MD 20678 | 2009-03-05 |
1225273519 | Rebecca Lynn Jahed | Audiologist | 3180 Blackberry Lane, Prince Frederick, MD 20678 | 2008-12-16 |
1669639209 | Ralph Walter Niemann | Dentist | 272 Merrimac Court, Prince Frederick, MD 20678 | 2008-05-21 |
Find all providers in zip 20678 |
Taxonomy Code | 261QP2000X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Physical Therapy |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1982055323 | Phoenix Physical Therapy and Fitness | Clinic/Center | 230 W Dares Beach Rd, Prince Frederick, MD 20678-3150 | 2016-06-27 |
1780889154 | K Conway Physical Therapy, Inc. | Clinic/Center | 110 Main Street, Prince Frederick, MD 20678 | 2007-06-18 |
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1083224877 | Silver Lining Physical Therapy & Wellness | Clinic/Center | 7050 Oakland Mills Rd Ste 130, Columbia, MD 21046-2269 | 2020-08-06 |
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1891312575 | Flamm Physical Therapy and Wellness, LLC | Clinic/Center | 2801 Guilford Ave, Baltimore, MD 21218-5485 | 2020-06-29 |
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1851917892 | Mgpt, LLC | Clinic/Center | 5901 Montrose Rd Apt N402, Rockville, MD 20852-4729 | 2020-06-24 |
1811513278 | Manigault Enterprise, L.L.C. | Clinic/Center | 2103 Woodtop Way, Bel Air, MD 21015-6370 | 2020-06-22 |
1114543089 | True Sports Physical Therapy, LLC | Clinic/Center | 9030 State Route 108 Ste B, Columbia, MD 21045-1990 | 2020-06-17 |
1427673482 | True Sports Physical Therapy, LLC | Clinic/Center | 1305 Governors Ct Ste D, Abingdon, MD 21009-2345 | 2020-06-15 |
Find all providers with the same taxonomy |
City | PRINCE FREDERICK |
Zip Code | 20678 |
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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.