PHS MULTISPECIALTY SERVICES (NPI# 1134598394) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134598394 |
| Entity Type | Organization |
| Organization Name | PHS MULTISPECIALTY SERVICES |
| Other Organization Name | PROVIDENCE HEALTH SERVICES, INC |
| Practice Address |
14300 Gallant Fox Ln Suite 224 Bowie MD 20715-4003 |
| Mailing Address |
1160 Varnum St Ne St Catherine's Hall, Room 102 Washington DC 20017-2107 |
| Practice Telephone | 3012628291 |
| Practice Fax Number | 3012627740 |
| Mailing Telephone | 2028544069 |
| Mailing Fax Number | 2028547825 |
| Enumeration Date | 2015-09-17 |
| Last Update Date | 2017-10-09 |
| Authorized Official Name | BEAU HIGGINBOTHAM (VICE PRESIDENT/COO) |
| Authorized Official Telephone | 4103683162 |
| Is Organization Subpart | Y |
| Parent Organization Name | PROVIDENCE HOSPITAL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | HFD01-0212 | DC | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Providence Health Services, Inc | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063780674 | Phs Multispecialty Services | General Acute Care Hospital | 1160 Varnum St Ne, Depaul 300, Washington, DC 20017-2107 | 2011-12-09 |
| Street Address |
14300 GALLANT FOX LN SUITE 224 |
| City | BOWIE |
| State | MD |
| Zip Code | 20715-4003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154322659 | Theodore W Taber | Chiropractor | 14300 Gallant Fox Ln, Suite 201, Bowie, MD 20715-4003 | 2005-08-09 |
| 1598318545 | Bonita Mannings | Counselor | 14300 Gallant Fox Ln, Bowie, MD 20715-4003 | 2019-07-18 |
| 1740796945 | Tierra Shanel Thomas | Nurse Practitioner | 14300 Gallant Fox Ln, Bowie, MD 20715-4003 | 2017-12-26 |
| 1821532813 | Neuroscience Associates of Bowie | Clinical Neuropsychologist | 14300 Gallant Fox Ln, 107, Bowie, MD 20715-4003 | 2016-12-09 |
| 1285082644 | Trinity Dental Care, LLC | Dentist | 14300 Gallant Fox Ln, Suite 111, Bowie, MD 20715-4003 | 2016-05-26 |
| 1285094094 | Love Kids LLC | Pediatrics | 14300 Gallant Fox Ln, 203, Bowie, MD 20715-4003 | 2016-03-07 |
| 1417322926 | Shannon Nicole Martin | Nurse Practitioner | 14300 Gallant Fox Ln, Suite 216, Bowie, MD 20715-4003 | 2015-12-09 |
| 1780078436 | Utopia Health Services Group Inc. | Counselor | 14300 Gallant Fox Ln, Suite 213, Bowie, MD 20715-4003 | 2015-03-19 |
| 1083018832 | Marsha Ross | Social Worker | 14300 Gallant Fox Ln, Suite 216, Bowie, MD 20715-4003 | 2014-10-22 |
| 1215366752 | Healing Children and Families, Inc. | Social Worker | 14300 Gallant Fox Ln, Suite 216, Bowie, MD 20715-4003 | 2013-11-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104304757 | Aynia V Dorsey | Occupational Therapist | 6915 Laurel Bowie Rd Ste 205b, Bowie, MD 20715 | 2018-08-04 |
| 1558852988 | Dmv Foot and Ankle Center | Podiatrist | 15480 Annapolis Rd Ste 202-437, Bowie, MD 20715 | 2018-05-22 |
| 1861918435 | Ryan Leigh Brown | Psychologist | 3231 Superior Lane, Suite, A6, Bowie, MD 20715 | 2017-08-16 |
| 1073060430 | Chinwendu Ezeoru | Nurse Practitioner | 13004 Viewpoint Ln, Bowie, MD 20715 | 2016-09-02 |
| 1386094977 | Harris Teeter LLC | Durable Medical Equipment & Medical Supplies | 15501 Annapolis Rd, Suite 400, Bowie, MD 20715 | 2016-06-15 |
| 1083003164 | Megan Elizabeth Cooper | Social Worker | 2812 Bosworth Ln, Bowie, MD 20715 | 2015-01-13 |
| 1467856740 | Nathan-todd Consulting | Community/Behavioral Health | 3231 Superior Court Lane,# A5, Bowie, MD 20715 | 2014-10-15 |
| 1841534468 | Varsity Professional Rehabilitation and Staffing, LLC | Physical Therapist | 14000 Jericho Park Road, Bowie, MD 20715 | 2012-11-20 |
| 1013269893 | Felix Chukwudi Ohams | Registered Nurse | 7613 Old Chapel Dr, Bowie, MD 20715 | 2012-10-04 |
| 1720336464 | Tara Marie Hatfield | Physical Therapist | 100 Whitemarsh Park Drive, Bowie, MD 20715 | 2012-08-28 |
| Find all providers in zip 20715 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366988925 | Anne Arundel Physician Group, LLC | Surgery | 4175 N Hanson Ct, Suite 201, Bowie, MD 20716-3179 | 2017-01-06 |
| 1205154853 | Anne Arundel Physician Group, LLC | Surgery | 4175 N Hanson Ct, Suite 201, Bowie, MD 20716-3179 | 2010-05-06 |
| 1023345253 | Anne Arundel Medical Center, Inc | Surgery | 4175 N Hanson Ct, 201, Bowie, MD 20716-3179 | 2009-11-09 |
| 1104887272 | Surinder S Aujla | Surgery | 1010 N Mill St, Bowie, TX 76230-3120 | 2006-03-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477187052 | Anne Arundel Physician Group, LLC | Surgery | 8116 Good Luck Rd Ste 215, Lanham, MD 20706-3508 | 2020-02-24 |
| 1790246429 | Susan Voss | Surgery | 11402 Allview Dr, Beltsville, MD 20705-3503 | 2019-03-26 |
| 1356806236 | Post-acute Care & Geriatric Surgery LLC | Surgery | 111 Hamlet Hill Rd Unit 911, Baltimore, MD 21210-1513 | 2019-02-05 |
| 1114447935 | Claro Pioroda | Surgery | 1805 Blakefield Cir, Lutherville, MD 21093-4406 | 2017-06-22 |
| 1891220018 | Frank Lewis Jr. | Surgery | 30475 River Rd, Millington, MD 21651-1308 | 2017-04-25 |
| 1003367566 | Robert Marriott Medical Corp | Surgery | 713 Midway Ave, Mount Airy, MD 21771-2833 | 2016-10-19 |
| 1770934788 | Saurabh Gupta | Surgery | 15 S Exeter St, Baltimore, MD 21202-4603 | 2016-06-30 |
| 1619332475 | John Dylan Luck | Surgery | 5401 Old Court Rd Dept Of, Randallstown, MD 21133-5103 | 2015-12-22 |
| 1427426337 | Leodegario Ayson Najera Sr. | Surgery | 121 Flying Ebony Place, Havre De Grace, MD 21078 | 2015-09-09 |
| 1477942555 | John Alan Singer | Surgery | 24 Roland Green, Baltimore, MD 21210 | 2015-01-13 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on PHS MULTISPECIALTY SERVICES.
| 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.