BON SECOURS BALTIMORE PHYSICIAN GROUP LLC (NPI# 1972862027) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972862027 |
| Entity Type | Organization |
| Organization Name | BON SECOURS BALTIMORE PHYSICIAN GROUP LLC |
| Other Organization Name | PRIMARY CARE GROUP |
| Practice Address |
1940 W Baltimore St 3rd Floor Baltimore MD 21223-2245 |
| Mailing Address |
2000 W Baltimore St Physician Services Baltimore MD 21223-1558 |
| Practice Telephone | 4103623603 |
| Enumeration Date | 2012-05-10 |
| Last Update Date | 2012-05-10 |
| Authorized Official Name | SAMUEL L ROSS (CEO) |
| Authorized Official Telephone | 4103623000 |
| Authorized Official Credential | MD, MS |
| Is Organization Subpart | Y |
| Parent Organization Name | BON SECOURS HOSPITAL BALTIMORE INC |
| Parent Organization TIN |
|
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| PRIMARY CARE GROUP | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457606196 | Bon Secours Baltimore Physician Group LLC | Internal Medicine | 2000 West Baltimore Street, Phys Svcs, Baltimore, MD 21223 | 2012-07-18 |
| 1427313972 | Bon Secours Baltimore Physician Group LLC | Anesthesiology | 2000 West Baltimore Street; Phys Serv, Baltimore, MD 21223-1557 | 2012-07-11 |
| 1326303744 | Bon Secours Baltimore Physician Group LLC | Internal Medicine | 2000 W Baltimore St, Physician Services, Baltimore, MD 21223-1558 | 2012-07-11 |
| Street Address |
1940 W BALTIMORE ST 3RD FLOOR |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21223-2245 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538138185 | Maryland Nephrology Clinic LLC | Internal Medicine | 1940 W Baltimore St, Baltimore, MD 21223-2245 | 2006-03-16 |
| 1801365101 | Felicia Dalphine Bailey | Nurse Practitioner | 1940 W Baltimore St, Baltimore, MD 21223-2245 | 2018-11-15 |
| 1093054298 | Preetinder S. Sandhu, Md, LLC | Internal Medicine | 1940 W Baltimore St, Baltimore, MD 21223-2245 | 2013-02-07 |
| 1801135439 | Grace Medical Center, Inc. | Family Medicine | 1940 W Baltimore St, 3rd Floor, Baltimore, MD 21223-2245 | 2013-02-01 |
| 1154511889 | Temitope A Olumoko | Physician Assistant | 1940 W Baltimore St, 3rd Floor, Baltimore, MD 21223-2245 | 2007-07-30 |
| 1255546263 | Jean Albert Midy Md Pa | Surgery | 1940 W Baltimore St, Baltimore, MD 21223-2245 | 2007-05-12 |
| 1417162439 | Anthony R Joseph Md LLC | Internal Medicine | 1940 W Baltimore St, Baltimore, MD 21223-2245 | 2007-05-12 |
| 1306051321 | John Braxton Md | Family Medicine | 1940 W Baltimore St, Baltimore, MD 21223-2245 | 2007-05-12 |
| 1114132131 | Preetender Sandhu Md | Family Medicine | 1940 W Baltimore St, Baltimore, MD 21223-2245 | 2007-05-12 |
| 1184839102 | Ufomadu & Associates Inc | Internal Medicine | 1940 W Baltimore St, Baltimore, MD 21223-2245 | 2007-05-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649743972 | Dominique Olivier | Nurse Practitioner | Bon Secours Hospital, 2000 West Baltimore Street, Baltimore, MD 21223 | 2019-01-09 |
| 1659858769 | Millicent Boa-amponsem | Registered Nurse | 907 Ramsay St, Baltimore, MD 21223 | 2018-07-20 |
| 1023527231 | University Psychological Center, Inc | Substance Abuse Rehabilitation Facility | 13-19 South Fulton Avenue, Baltimore, MD 21223 | 2017-09-20 |
| 1245766468 | University Psychological Center, Inc | Substance Abuse Rehabilitation Facility | 1208-10 James Street, Baltimore, MD 21223 | 2017-05-08 |
| 1750737599 | Natasia D Brown | Social Worker | 1501 W. Saratoga St., Baltimore, MD 21223 | 2016-05-11 |
| 1104298355 | Independence Foundation, Inc. | Community/Behavioral Health | 13 S. Carrollton Ave, Baltimore, MD 21223 | 2015-10-28 |
| 1588095087 | Jr Healthcare Associates Dba Baltimore Behavioral Health | Clinic/Center | 1101 W. Pratt St., Baltimore, MD 21223 | 2013-12-09 |
| 1639501448 | Behavioral Health Network LLC | Counselor | 1101 W. Pratt Street, Baltimore, MD 21223 | 2013-08-02 |
| 1457606196 | Bon Secours Baltimore Physician Group LLC | Internal Medicine | 2000 West Baltimore Street, Phys Svcs, Baltimore, MD 21223 | 2012-07-18 |
| 1790060317 | Bestcare Pharmacy, Inc | Pharmacy | 3061 Frederick Avenue, Baltimore, MD 21223 | 2011-10-14 |
| Find all providers in zip 21223 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891303038 | Lorenzo Leggio | General Practice | Nih/nida, Bayview Campus, Brc, 251 Bayview Boulevard, Room 01a844, Baltimore, MD 21224 | 2020-07-14 |
| 1083247894 | Medstar Medical Group II LLC | General Practice | 9101 Franklin Square Drive, Ste 200, Medical Arts Building, Baltimore, MD 21237-4072 | 2020-02-20 |
| 1326574799 | Marife Ann Ortega Teague | General Practice | 226 E 39th St, Baltimore, MD 21218 | 2017-05-04 |
| 1295199826 | Michael Rozak | General Practice | 3001 S Hanover St Dept Of, Baltimore, MD 21225-1233 | 2016-04-10 |
| 1114380433 | Ryan Sutherland | General Practice | Diagnostic Radiology and Nuclear Medicine, 22 S Greene St, Baltimore, MD 21201 | 2016-04-04 |
| 1386028900 | Christopher Kircher | General Practice | 1016 S Robinson St, Baltimore, MD 21224-4937 | 2015-07-14 |
| 1437549466 | Health Alliance Associates | General Practice | 13 Hamilton Street, Baltimore, MD 21202-2120 | 2015-01-29 |
| 1952707903 | Bannister Lee Raines Jr. | General Practice | 1325 Bedford Ave Unit 21499, Baltimore, MD 21282-7525 | 2014-11-18 |
| 1437589868 | Peoples Community Health Center, Inc. | General Practice | 1734 Maryland Avenue, Baltimore, MD 21201 | 2013-11-21 |
| 1417245101 | Matthew Feeley | General Practice | 615 N Wolfe St Ste Wb602, Baltimore, MD 21205-2103 | 2011-07-14 |
| Find all providers in BALTIMORE | ||||
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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.