UNIVERSITY OF MARYLAND COMMUNITY MEDICAL GROUP, INC. (NPI# 1295367894) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295367894 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY OF MARYLAND COMMUNITY MEDICAL GROUP, INC. |
| Practice Address |
301 Hospital Dr Glen Burnie MD 21061-5803 |
| Mailing Address |
900 Elkridge Landing Rd Fl 2 Linthicum MD 21090-2924 |
| Practice Telephone | 4107874000 |
| Enumeration Date | 2020-02-11 |
| Last Update Date | 2020-02-11 |
| Authorized Official Name | JOANNE R HAHEY (CFO) |
| Authorized Official Telephone | 4108221000 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477530624 | University of Maryland Community Medical Group, Inc. | Pediatrics | 900 Elkridge Landing Rd Fl 2, Linthicum, MD 21090-2924 | 2005-12-29 |
| 1912407222 | University of Maryland Community Medical Group, Inc. | Psychiatry & Neurology | 301 Hospital Dr, Glen Burnie, MD 21061-5803 | 2018-02-14 |
| 1447419049 | University of Maryland Community Medical Group, Inc. | Radiology | 305 Hospital Dr, Glen Burnie, MD 21061-5805 | 2008-06-09 |
| Street Address |
301 HOSPITAL DR |
| City | GLEN BURNIE |
| State | MD |
| Zip Code | 21061-5803 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184627507 | Richard Alan Kelton | Preventive Medicine | 301 Hospital Dr, Glen Burnie, MD 21061-5803 | 2005-05-31 |
| 1871194662 | Rachel Ann Sands | Pharmacist | 301 Hospital Dr, Glen Burnie, MD 21061-5803 | 2020-11-06 |
| 1912507500 | Ca'seem Tyler | Nurse Practitioner | 301 Hospital Dr, Glen Burnie, MD 21061-5803 | 2020-11-01 |
| 1043818651 | Michael Booth | Registered Nurse | 301 Hospital Dr, Glen Burnie, MD 21061-5803 | 2020-10-15 |
| 1912504598 | Rachel Janine Weitman | Physician Assistant | 301 Hospital Dr, Glen Burnie, MD 21061-5803 | 2020-10-06 |
| 1689288359 | Candace Katelynn Fazenbaker | Nurse Practitioner | 301 Hospital Dr, Glen Burnie, MD 21061-5803 | 2020-09-01 |
| 1699385542 | Amanda Theresa Bailey | Nurse Practitioner | 301 Hospital Dr, Glen Burnie, MD 21061-5803 | 2020-08-05 |
| 1639797046 | Gloria Owusu-seshie | Nurse Practitioner | 301 Hospital Dr, Glen Burnie, MD 21061-5803 | 2020-07-13 |
| 1447876693 | Ming Li | Nurse Anesthetist, Certified Registered | 301 Hospital Dr, Glen Burnie, MD 21061-5803 | 2020-06-23 |
| 1033735279 | Elodie Tendoh | Student in an Organized Health Care Education/Training Program | 301 Hospital Dr, Glen Burnie, MD 21061-5803 | 2020-06-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255814422 | Lotus Behavioral Health and Rehabilitation Services Inc. | Behavior Technician | 6426 Harrison Square, Glen Burnie, MD 21061 | 2018-09-12 |
| 1942795315 | Tina Brown | Behavior Technician | Rise for Autism, 510 Mccormick Drive, Ste. U-w, Glen Burnie, MD 21061 | 2018-06-27 |
| 1205351905 | Digna Emerita Sanchez De Vasquez | Specialist/Technologist, Other | 201 Fernglen Ave, Glen Burnie, MD 21061 | 2017-08-03 |
| 1255780300 | Rachel Cutts | Physical Therapist | 7711 Quarterfield Rd Ste C2, Glen Burnie, MD 21061 | 2016-06-09 |
| 1295181170 | Gaudenzia, Inc. | Counselor | 5 Crain Highway North - Rear Suite Entrance, Glen Burnie, MD 21061 | 2016-05-10 |
| 1023499548 | Mary Bourbon | Nurse Practitioner | 1600 S. Cain Highway, Suite 401, Glen Burnie, MD 21061 | 2015-06-10 |
| 1972997724 | Robert Oladeinde | Physician Assistant | 6934 Aviation Blvd Suite B, Glen Burnie, MD 21061 | 2015-03-18 |
| 1205248069 | Cathy Qing He | Anesthesiology | 1600 Crain Hwy S Ste 301, Glen Burnie, MD 21061 | 2014-05-28 |
| 1477974764 | Shannon Holder | Nurse Practitioner | 1916 Crain Hwy S Ste 2, Glen Burnie, MD 21061 | 2014-01-03 |
| 1629404207 | Marla Ann Muha | Physician Assistant | 301 Hospital Dr # 803, Glen Burnie, MD 21061 | 2013-09-16 |
| Find all providers in zip 21061 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669840476 | Parker James Barrett | Physician Assistant | 301 Hospital Dr, Glen Burnie, MD 21061-5803 | 2015-09-10 |
| 1750783858 | Megan Bell | Physician Assistant | 301 Hospital Dr, Glen Burnie, MD 21061-5803 | 2014-09-19 |
| 1104236959 | Surgical Assist Services LLC | Physician Assistant | 1600 Crain Hwy S, Ste 401, Glen Burnie, MD 21061-5577 | 2014-05-02 |
| 1659705440 | Victoria A. Yonowitz | Physician Assistant | 301 Hospital Dr, Glen Burnie, MD 21061-5803 | 2013-08-28 |
| 1619221959 | Bridget K. Haslam | Physician Assistant | 331 Oak Manor Dr, Suite 201, Glen Burnie, MD 21061-5548 | 2012-11-08 |
| 1124281951 | Jane Lenore Miclay | Physician Assistant | 203 Hospital Dr, Suite B100, Glen Burnie, MD 21061-6904 | 2008-07-02 |
| 1215106067 | Steven W Sullivan | Physician Assistant | 1600 Crain Hwy S, Suite 401, Glen Burnie, MD 21061-5577 | 2008-02-26 |
| 1023034170 | Brian Roeder | Physician Assistant | 301 Hospital Dr, Suite 803, Glen Burnie, MD 21061-5803 | 2006-07-14 |
| 1598726978 | Ivona M Banham | Physician Assistant | 200 Hospital Dr, Glen Burnie, MD 21061-5884 | 2006-03-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205475803 | Kendy Karenys Lopez | Physician Assistant | 18324 Streamside Dr Apt 204, Gaithersburg, MD 20879-5228 | 2019-12-30 |
| 1528619640 | Cindy Pham | Physician Assistant | 7515 Oyster Bay Way, Gaithersburg, MD 20886-5905 | 2019-09-20 |
| 1508336637 | Victor Orlando Hernandez | Physician Assistant | 125 Potomac Psge Unit 200, Oxon Hill, MD 20745-1580 | 2018-12-02 |
| 1164905824 | Surgical Focus LLC | Physician Assistant | 5550 Friendship Blvd Ste 100, Chevy Chase, MD 20815-7294 | 2018-09-10 |
| 1912497173 | Gem Y Walker Lawson | Physician Assistant | 6500 Rock Spring Dr Ste 100, Bethesda, MD 20817-1182 | 2018-05-14 |
| 1306341540 | Sunil Harris | Physician Assistant | 22 S. Green St, University of Maryland Medical Center, Baltimore, MD 21201-1595 | 2018-03-29 |
| 1134639263 | Liz Ramirez | Physician Assistant | 1101 E 33rd St, Baltimore, MD 21218-3637 | 2017-10-03 |
| 1093231755 | Daniel Gentry | Physician Assistant | 301 Saint Paul St Ste Pob 802, Baltimore, MD 21202-2102 | 2017-08-15 |
| 1467981431 | Lana E Grubb | Physician Assistant | 12502 Willowbrook Rd Ste 470, Cumberland, MD 21502-6593 | 2017-06-05 |
| 1174051353 | Nam Anh Pham | Physician Assistant | 227 Saint Paul St Fl 6, Baltimore, MD 21202-2001 | 2017-05-31 |
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| City | GLEN BURNIE |
| Zip Code | 21061 |
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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.