BON SECOURS BALTIMORE PHYSICIAN GROUP LLC (NPI# 1326303744) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326303744 |
| Entity Type | Organization |
| Organization Name | BON SECOURS BALTIMORE PHYSICIAN GROUP LLC |
| Other Organization Name | INTERNAL MEDICINE |
| Practice Address |
2000 W Baltimore St Physician Services Baltimore MD 21223-1558 |
| Practice Telephone | 4103633603 |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2012-07-24 |
| Authorized Official Name | DR. 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 | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| INTERNAL MEDICINE | 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 |
| 1972862027 | Bon Secours Baltimore Physician Group LLC | General Practice | 1940 W Baltimore St, 3rd Floor, Baltimore, MD 21223-2245 | 2012-05-10 |
| Street Address |
2000 W BALTIMORE ST PHYSICIAN SERVICES |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21223-1558 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962480772 | Grace Medical Center, Inc. | General Acute Care Hospital | 2000 W Baltimore St, Baltimore, MD 21223-1558 | 2006-01-03 |
| 1538724604 | Oluwatosin A Fanimo | Nurse Practitioner | 2000 W Baltimore St, Baltimore, MD 21223-1558 | 2019-05-04 |
| 1003382433 | Christina Joy Williamson | Nurse Practitioner | 2000 W Baltimore St, Baltimore, MD 21223-1558 | 2018-10-24 |
| 1447768072 | Francine Dorothea Madden | Nurse Practitioner | 2000 W Baltimore St, Baltimore, MD 21223-1558 | 2018-01-17 |
| 1407365760 | Kathryn Diana Violette | Dietitian, Registered | 2000 W Baltimore St, Baltimore, MD 21223-1558 | 2017-09-29 |
| 1992226872 | Sara Foresman | Dietitian, Registered | 2000 W Baltimore St, Baltimore, MD 21223-1558 | 2017-06-30 |
| 1114478559 | Bon Secours Hospital Baltiimore Ind | General Acute Care Hospital | 2000 W Baltimore St, Baltimore, MD 21223-1558 | 2016-10-20 |
| 1497205066 | Bon Secours Hospital Baltimore, Inc | General Acute Care Hospital | 2000 W Baltimore St, Baltimore, MD 21223-1558 | 2016-10-07 |
| 1831649466 | Bon Secours Hospital Baltimore, Inc | Psychiatric Unit | 2000 W Baltimore St, Baltimore, MD 21223-1558 | 2016-10-06 |
| 1558811240 | Bon Secours Hospital Baltimore Inc | General Acute Care Hospital | 2000 W Baltimore St, Baltimore, MD 21223-1558 | 2016-10-06 |
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| 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 | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| 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 Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184272296 | Federal Hill Pediatric Center | Internal Medicine | 724 Light St Ste A, Baltimore, MD 21230-3813 | 2019-09-02 |
| 1861051096 | Intermed Associates Ipa, LLC | Internal Medicine | 9106 Philadelphia Rd Ste 214, Baltimore, MD 21237-4333 | 2019-06-11 |
| 1720540925 | Johns Hopkins Community Physicians | Internal Medicine | 5210 Eastern Ave Ste 127, Baltimore, MD 21224-2719 | 2019-04-05 |
| 1013488188 | Atlantic Medical Associates, LLC | Internal Medicine | 6717 Park Heights Ave Lowr Level, Baltimore, MD 21215-2443 | 2018-12-16 |
| 1700386109 | Burke Medical, P.C. | Internal Medicine | 8 Market Pl Ste 300, Baltimore, MD 21202-4113 | 2018-02-13 |
| 1538695598 | Hisham Ahmed Farhan | Internal Medicine | 827 Linden Ave # B-2043, Baltimore, MD 21201-4606 | 2017-05-11 |
| 1538692652 | Thi Khuc | Internal Medicine | 22 S Greene St # N3w156, Baltimore, MD 21201-1544 | 2017-04-05 |
| 1053868646 | Apurva Sharma | Internal Medicine | 600 N Wolfe St Blalock 545, Baltimore, MD 21287-1766 | 2016-09-01 |
| 1053761031 | Seyed Mohammad Hodanazari | Internal Medicine | 727 W 40th St # A215, Baltimore, MD 21211-2105 | 2016-06-21 |
| 1568824522 | Alaina Christine Chodoff | Internal Medicine | 2024 E Monument St Fl 2, Baltimore, MD 21287-0028 | 2016-03-28 |
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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.