CIVISTA MEDICAL CENTER INC. (NPI# 1992701825) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992701825 |
| Entity Type | Organization |
| Organization Name | CIVISTA MEDICAL CENTER INC. |
| Practice Address |
5 Garrett Ave La Plata MD 20646-5960 |
| Mailing Address |
Po Box 1070 La Plata MD 20646-1070 |
| Practice Telephone | 3016094474 |
| Practice Fax Number | 3016094411 |
| Mailing Telephone | 3016095163 |
| Mailing Fax Number | 3019340053 |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2020-05-27 |
| Authorized Official Name | ALBERT ZANGER (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 3016095163 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 282NR1301X |
General Acute Care Hospital Specialization: Rural |
========= | MD | Hospitals |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 003355200 | 05 |
| Street Address |
5 GARRETT AVE |
| City | LA PLATA |
| State | MD |
| Zip Code | 20646-5960 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245883685 | Dena R Marseglia | Registered Nurse | 5 Garrett Ave, La Plata, MD 20646-5960 | 2019-07-23 |
| 1326514613 | Brandon Timothy Pace | Nurse Anesthetist, Certified Registered | 5 Garrett Ave, La Plata, MD 20646-5960 | 2018-10-15 |
| 1841776531 | Naureen Khan | Internal Medicine | 5 Garrett Ave, La Plata, MD 20646-5960 | 2018-07-16 |
| 1366932287 | Mamata Blon | Physician Assistant | 5 Garrett Ave, La Plata, MD 20646-5960 | 2018-05-16 |
| 1962910794 | Laanita Gillispie | Registered Nurse | 5 Garrett Ave, La Plata, MD 20646-5960 | 2018-01-15 |
| 1063925873 | Chelsea Dawn Hughes | Internal Medicine | 5 Garrett Ave, La Plata, MD 20646-5960 | 2017-11-15 |
| 1417479395 | Javonna O'brien | Registered Nurse | 5 Garrett Ave, La Plata, MD 20646-5960 | 2017-07-12 |
| 1841712254 | Qler Physician Medical Group, P.a. | Psychiatry & Neurology | 5 Garrett Ave, La Plata, MD 20646-5960 | 2017-07-07 |
| 1053840884 | Njideka Oguejiofor | Internal Medicine | 5 Garrett Ave, La Plata, MD 20646-5960 | 2017-06-06 |
| 1750730222 | Melissa James | Nurse Practitioner | 5 Garrett Ave, La Plata, MD 20646-5960 | 2016-06-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932718822 | Charles Regional Surgical Center LLC | Clinic/Center | 5 North Laplata Court, 2nd Floor, Laplata, MD 20646 | 2020-07-27 |
| 1902387988 | Sheldon Villarta | Physical Therapist | 10200 La Plata Town, La Plata, MD 20646 | 2018-08-27 |
| 1912485244 | Kelli Hill Goldsborough | Nurse Practitioner | 5 N La Plata Ct Ste 101, La Plata, MD 20646 | 2018-07-30 |
| 1083128490 | Charles County Rescue Squad Inc | Ambulance | 2 Calvert St, La Plata, MD 20646 | 2017-11-21 |
| 1801261532 | Catherine Deshetler | Social Worker | 5 N Maple Ave Ste 206, La Plata, MD 20646 | 2015-12-07 |
| 1215346481 | Brittany Godin | Speech-Language Pathologist | 5 Garrett Avenue, La Plata, MD 20646 | 2014-08-12 |
| 1558787606 | Homeplace Assisted Living | Assisted Living Facility | 10210 La Plata Rd, La Plata, MD 20646 | 2014-03-13 |
| 1891056628 | Godfrey T Hewitt | Dentist | 6620 Crain Hwy #204, Laplata, MD 20646 | 2012-06-07 |
| 1740573823 | Armida Bondoc Gonzales | Physical Therapist | 15 S Maple Ave, Apt 2, La Plata, MD 20646 | 2011-05-23 |
| 1023315348 | Charity E Dugan | Surgery | Um Charles Regional Medical Group, 5 North La Plata Court Ste 103, La Plata, MP 20646 | 2011-02-23 |
| Find all providers in zip 20646 | ||||
| Taxonomy Code | 282NR1301X |
| Grouping | Hospitals |
| Classification | General Acute Care Hospital |
| Specialization | Rural |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427318039 | Grace Acupuncture, LLC | General Acute Care Hospital | 13410 Clarksville Pike, Highland, MD 20777-9537 | 2012-05-17 |
| 1568874519 | Holy Cross Hospital | General Acute Care Hospital | 1500 Forest Glen Rd, Silver Spring, MD 20910-1460 | 2014-05-27 |
| 1063655611 | Union Memorial Hospital | General Acute Care Hospital | 201 E University Pkwy, 3333 North Calvert Street, Baltimore, MD 21218-2829 | 2009-04-13 |
| 1770691024 | St. Mary's Hospital of St. Mary's County, Inc | General Acute Care Hospital | 25500 Point Lookout Rd, Health Connections, Leonardtown, MD 20650-0527 | 2006-08-28 |
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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.