ANNAPOLIS ENT SURGERY CENTER LLC (NPI# 1629094917) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629094917 |
| Entity Type | Organization |
| Organization Name | ANNAPOLIS ENT SURGERY CENTER LLC |
| Practice Address |
2002 Medical Pkwy Suite 230a Annapolis MD 21401-3046 |
| Mailing Address |
Po Box 41470 Baltimore MD 21203-6470 |
| Practice Telephone | 4102663900 |
| Practice Fax Number | 4102668962 |
| Mailing Telephone | 4102663900 |
| Mailing Fax Number | 4102668962 |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. GREGORY HEACOCK (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 4102663900 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
A1360 | MD | Ambulatory Health Care Facilities |
| Street Address |
2002 MEDICAL PKWY SUITE 230A |
| City | ANNAPOLIS |
| State | MD |
| Zip Code | 21401-3046 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366448953 | Ayanna L James | Obstetrics & Gynecology | 2002 Medical Pkwy, Suite 635, Annapolis, MD 21401-3046 | 2005-06-28 |
| 1336611466 | Lauren Mason | Social Worker | 2002 Medical Pkwy, Annapolis, MD 21401-3046 | 2018-12-31 |
| 1184131542 | Amanda Nicole Minnitte | Physical Therapy Assistant | 2002 Medical Pkwy, Annapolis, MD 21401-3046 | 2018-01-08 |
| 1255878526 | Maryland Medicinal LLC | Physical Medicine & Rehabilitation | 2002 Medical Pkwy, Suite 150, Annapolis, MD 21401-3046 | 2017-01-25 |
| 1669917993 | Back To Fit Inc. | Physical Medicine & Rehabilitation | 2002 Medical Pkwy, 150, Annapolis, MD 21401-3046 | 2016-12-22 |
| 1821549528 | Anne Arundel Physician Group, LLC | Family Medicine | 2002 Medical Pkwy, Suite 460, Annapolis, MD 21401-3046 | 2016-10-18 |
| 1114372497 | Anne Arundel Physician Group, LLC | Clinical Neuropsychologist | 2002 Medical Pkwy, Suite 430, Annapolis, MD 21401-3046 | 2016-04-25 |
| 1487040036 | Gaurav Srivastava | Ophthalmology | 2002 Medical Pkwy, Annapolis, MD 21401-3046 | 2015-04-10 |
| 1164828679 | Med-park LLC | Pharmacy | 2002 Medical Pkwy, Ste 170, Annapolis, MD 21401-3046 | 2014-11-10 |
| 1992147631 | Zachary Scott La Fratta | Audiologist | 2002 Medical Pkwy, Suite 230 Sajak Building, Annapolis, MD 21401-3046 | 2013-07-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497377154 | Michael Khorsandi | Student in an Organized Health Care Education/Training Program | 2001 Medical Parkway, Clatanoff Pavillon, Gmw Office, Annapolis, MD 21401 | 2020-05-15 |
| 1275172033 | Katrice N Nelson | Massage Therapist | Wellsview Cottage Center, 613 Ridgely Avenue, Annapolis, MD 21401 | 2019-12-27 |
| 1548803521 | Victoria Reimnitz | Behavioral Analyst | 2028 Indusrtrial Dr, Ste B&c, Annapolis, MD 21401 | 2019-10-23 |
| 1700438140 | Emily Megan Burke | Nurse Practitioner | 200 Forbes St Annapolis, Md 21401, Suite 200, Annapolis, MD 21401 | 2019-07-16 |
| 1316504848 | Sherina Maryam Shamsa | Counselor | 1830 Forest Drive, Suite H-2, Annapolis, MD 21401 | 2019-05-21 |
| 1497225288 | Jerilyn Deitch | Speech-Language Pathologist | Anne Arundel County Public Schools, 2644 Riva Rd, Annapolis, MD 21401 | 2018-12-05 |
| 1487124038 | Lucinda W Mimms | Speech-Language Pathologist | 2644 Riva Rd., Annapolis, MD 21401 | 2018-11-27 |
| 1487145496 | Michelle Baudean | Behavior Technician | 1919 West St Ste 201, Annapolis, MD 21401 | 2018-05-24 |
| 1730678954 | Stephanie Ruth Streb | Registered Nurse | 130 Admiral Cochrane Dr Ste 103, Annapolis, MD 21401 | 2018-05-02 |
| 1780183947 | Annapolis Sleep Center LLC | Clinic/Center | 2451 Riva Rd, Annapolis, MD 21401 | 2018-02-02 |
| Find all providers in zip 21401 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1225665292 | Annapolis Endoscopy Center LLC | Clinic/Center | 1419 Forest Dr Ste 105, Annapolis, MD 21403-1474 | 2020-03-26 |
| 1154805646 | Anne Arundel-sca Surgicenter, LLC | Clinic/Center | 904 Commerce Rd, Annapolis, MD 21401-2948 | 2018-09-20 |
| 1619324068 | Annapolis Surgery Pavilion, LLC. | Clinic/Center | 166 Defense Hwy Ste 101, Annapolis, MD 21401-7034 | 2016-05-16 |
| 1902959190 | Riva Road Surgical Center, LLC | Clinic/Center | 2635 Riva Rd Ste 118, Annapolis, MD 21401-7430 | 2007-01-19 |
| 1790791598 | Annapolis Surgery Center, L.L.C. | Clinic/Center | 2629 Riva Road, Suite 106, Annapolis, MD 21401 | 2006-08-01 |
| 1285678979 | Bay Surgery Centers LLC | Clinic/Center | 116 Defense Hwy Ste 403b, Annapolis, MD 21401-7020 | 2006-06-15 |
| 1346215316 | Chesapeake Eye Surgery Center, LLC | Clinic/Center | 2002 Medical Parkway, Suite 330, Annapolis, MD 21401-7901 | 2006-02-22 |
| 1083279608 | Miguel R Garden Hernandez Md | Clinic/Center | 2001 Medical Pkwy, Annapolis, MD 21401-3773 | 2019-05-08 |
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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.