ADVANTIA HEALTH SPINE-SPORTS & PAIN CENTER OF MARYLAND LLC (NPI# 1629447453) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629447453 |
| Entity Type | Organization |
| Organization Name | ADVANTIA HEALTH SPINE-SPORTS & PAIN CENTER OF MARYLAND LLC |
| Practice Address |
12240 Indian Creek Ct Suite 130a Beltsville MD 20705-1242 |
| Mailing Address |
1400 Forest Glen Rd Ste 500 Silver Spring MD 20910-1467 |
| Practice Telephone | 5713271334 |
| Practice Fax Number | 2402648436 |
| Mailing Telephone | (301) 453-5970 |
| Enumeration Date | 2015-09-22 |
| Last Update Date | 2017-06-28 |
| Authorized Official Name | DR. PETER GLASS (CMO) |
| Authorized Official Telephone | 3014535970 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | ADVANTIA HOLDINGS OF MARYLAND LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
Allopathic & Osteopathic Physicians |
| Street Address |
12240 INDIAN CREEK CT SUITE 130A |
| City | BELTSVILLE |
| State | MD |
| Zip Code | 20705-1242 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215112537 | Ritu Varma | Anesthesiology | 12240 Indian Creek Ct, Ste 130a, Beltsville, MD 20705-1242 | 2008-01-05 |
| 1952784621 | Advantage Anesthesia of Maryland LLC | Anesthesiology | 12240 Indian Creek Ct, Suite 130, Beltsville, MD 20705-1242 | 2015-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235730318 | My Clinical Coordinator LLC | Nurse Practitioner | 11720 Belsville Drive, Suite 500-a44, Beltsville, MD 20705 | 2020-11-04 |
| 1306454129 | Anastasi Ward | Technician | 4009 Lakehouse Road, Beltsville, MD 20705 | 2020-07-17 |
| 1750942512 | City Access LLC | Pharmacy | 11466 Cherry Hill Road, Silver Spring, MD 20705 | 2019-06-24 |
| 1972089225 | Emily Hemphill | Behavior Technician | 3917 Howard Rd, Beltsville, MD 20705 | 2018-07-18 |
| 1457841629 | Vijayalakshmi Jesson Dds PC | Dentist | 10820 Rhode Island Ave Ste A, Beltsville, MD 20705 | 2018-05-14 |
| 1942704465 | Ana Lisette Cordon | Behavior Technician | 12603 Bear Creek Ter, Beltsville, MD 20705 | 2018-03-20 |
| 1841718608 | Premier Health Care LLC | Psychiatry & Neurology | 4600 Powder Mill Rd Ste Z1, Beltsville, MD 20705 | 2017-08-31 |
| 1104357094 | Byron Adams | Social Worker | 12050 Baltimore Avenue, Beltsville, MD 20705 | 2017-03-23 |
| 1598213936 | Suita Healthcare Services | Home Health | 4517 Sellman Road, Suit G, Beltsville, MD 20705 | 2016-09-14 |
| 1578910246 | Kadiatu Turay | Technician | 11457 Cherry Hiill Rd #303, Beltsville, MD 20705 | 2016-05-23 |
| Find all providers in zip 20705 | ||||
| Taxonomy Code | 207LP2900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| Specialization | Pain Medicine |
| An anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chronic and/or cancer pain in both hospital and ambulatory settings. Patient care needs are also coordinated with other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861986572 | Accessible Integrative Medicine, LLC | Anesthesiology | 30 W Gude Dr Ste 375, Rockville, MD 20850-4300 | 2018-06-16 |
| 1760979116 | Advanced Pain Management Specialists, LLC | Anesthesiology | 331 Oak Manor Dr Ste 102, Glen Burnie, MD 21061-5553 | 2018-04-20 |
| 1407367055 | Consuelo Delores Fernandez | Anesthesiology | 6196 Oxon Hill Rd Ste 210, Oxon Hill, MD 20745-3137 | 2017-10-22 |
| 1598217291 | Advanced Pain Management Specialists, LLC | Anesthesiology | 10905 Fort Washington Rd Ste 405, Ft Washington, MD 20744-5807 | 2016-10-28 |
| 1104280957 | Brent Earls | Anesthesiology | 601 N Caroline St # 3062, Baltimore, MD 21287-0006 | 2016-04-07 |
| 1306213186 | Matsunaga Pain Management LLC | Anesthesiology | 8894 Stanford Blvd., Suite 104, Columbia, MD 21045-5161 | 2015-08-27 |
| 1801213863 | Jonathan Sean Woo | Anesthesiology | 22 South Greene Street, Room S11c00, Anestheisology, Baltimore, MD 21201 | 2014-03-27 |
| 1437409844 | Romana Baig | Anesthesiology | 1000 Bestgate Rd, Ste 400, Annapolis, MD 21401-3371 | 2012-09-12 |
| 1730455155 | Kim Vuong Hoang | Anesthesiology | 8455 Colesville Rd Ste 200, Silver Spring, MD 20910 | 2012-03-29 |
| 1295026342 | Anesthesia and Interventional Pain Management Center | Anesthesiology | 12821 Oak Hill Ave Ste 2, Hagerstown, MD 21742-2937 | 2011-04-25 |
| Find all providers with the same taxonomy | ||||
| City | BELTSVILLE |
| Zip Code | 20705 |
Please comment or provide details below to improve the information on ADVANTIA HEALTH SPINE-SPORTS & PAIN CENTER OF MARYLAND 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.