DR. JACK J VAN GEFFEN (NPI# 1487656245) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1487656245 |
Entity Type | Individual |
Full Name | DR. JACK J VAN GEFFEN |
Credential | M.D. |
Practice Address |
2002 Medical Pkwy Suite 235 Annapolis MD 21401-3046 |
Practice Telephone | 4102662770 |
Practice Fax Number | 4108416251 |
Mailing Telephone | 4102662770 |
Mailing Fax Number | 4108416251 |
Enumeration Date | 2005-08-11 |
Last Update Date | 2010-11-16 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2085N0904X |
Radiology Specialization: Nuclear Radiology |
D0019967 | MD | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MD | BCBS | 10690008 | 01 |
MD | AETNA HMO/POS | 2622593 | 01 |
MD | AAD AA COUNTY | JG95 | 01 |
MD | AAD SHIPLEYS | 494M | 01 |
MD | TRAVELERS RR MEDICARE | 300031317 | 01 |
MD | AAD PG COUNTY | A14 | 01 |
MD | AETNA PPO | 8317071 | 01 |
MD | MEDICARE SHIPLEYS IMAGING | 1487656245 | 01 |
MD | PTAN DC BOWIE | 414894ZED1 | 01 |
MD | 155951600 | 05 |
Street Address |
2002 MEDICAL PKWY SUITE 235 |
City | ANNAPOLIS |
State | MD |
Zip Code | 21401-3046 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1366448953 | Ayanna L James | Obstetrics & Gynecology | 2002 Medical Pkwy, Suite 635, Annapolis, MD 21401-3046 | 2005-06-28 |
1336611466 | Lauren Mason | Social Worker | 2002 Medical Pkwy, Annapolis, MD 21401-3046 | 2018-12-31 |
1184131542 | Amanda Nicole Minnitte | Physical Therapy Assistant | 2002 Medical Pkwy, Annapolis, MD 21401-3046 | 2018-01-08 |
1255878526 | Maryland Medicinal LLC | Physical Medicine & Rehabilitation | 2002 Medical Pkwy, Suite 150, Annapolis, MD 21401-3046 | 2017-01-25 |
1669917993 | Back To Fit Inc. | Physical Medicine & Rehabilitation | 2002 Medical Pkwy, 150, Annapolis, MD 21401-3046 | 2016-12-22 |
1821549528 | Anne Arundel Physician Group, LLC | Family Medicine | 2002 Medical Pkwy, Suite 460, Annapolis, MD 21401-3046 | 2016-10-18 |
1114372497 | Anne Arundel Physician Group, LLC | Clinical Neuropsychologist | 2002 Medical Pkwy, Suite 430, Annapolis, MD 21401-3046 | 2016-04-25 |
1487040036 | Gaurav Srivastava | Ophthalmology | 2002 Medical Pkwy, Annapolis, MD 21401-3046 | 2015-04-10 |
1164828679 | Med-park LLC | Pharmacy | 2002 Medical Pkwy, Ste 170, Annapolis, MD 21401-3046 | 2014-11-10 |
1992147631 | Zachary Scott La Fratta | Audiologist | 2002 Medical Pkwy, Suite 230 Sajak Building, Annapolis, MD 21401-3046 | 2013-07-23 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1497377154 | Michael Khorsandi | Student in an Organized Health Care Education/Training Program | 2001 Medical Parkway, Clatanoff Pavillon, Gmw Office, Annapolis, MD 21401 | 2020-05-15 |
1275172033 | Katrice N Nelson | Massage Therapist | Wellsview Cottage Center, 613 Ridgely Avenue, Annapolis, MD 21401 | 2019-12-27 |
1548803521 | Victoria Reimnitz | Behavioral Analyst | 2028 Indusrtrial Dr, Ste B&c, Annapolis, MD 21401 | 2019-10-23 |
1700438140 | Emily Megan Burke | Nurse Practitioner | 200 Forbes St Annapolis, Md 21401, Suite 200, Annapolis, MD 21401 | 2019-07-16 |
1316504848 | Sherina Maryam Shamsa | Counselor | 1830 Forest Drive, Suite H-2, Annapolis, MD 21401 | 2019-05-21 |
1497225288 | Jerilyn Deitch | Speech-Language Pathologist | Anne Arundel County Public Schools, 2644 Riva Rd, Annapolis, MD 21401 | 2018-12-05 |
1487124038 | Lucinda W Mimms | Speech-Language Pathologist | 2644 Riva Rd., Annapolis, MD 21401 | 2018-11-27 |
1487145496 | Michelle Baudean | Behavior Technician | 1919 West St Ste 201, Annapolis, MD 21401 | 2018-05-24 |
1730678954 | Stephanie Ruth Streb | Registered Nurse | 130 Admiral Cochrane Dr Ste 103, Annapolis, MD 21401 | 2018-05-02 |
1780183947 | Annapolis Sleep Center LLC | Clinic/Center | 2451 Riva Rd, Annapolis, MD 21401 | 2018-02-02 |
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Taxonomy Code | 2085N0904X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Radiology |
Specialization | Nuclear Radiology |
A radiologist who is involved in the analysis and imaging of radionuclides and radiolabeled substances in vitro and in vivo for diagnosis and the administration of radionuclides and radiolabeled substances for the treatment of disease. |
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 Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609229228 | Reema Goel | Radiology | 601 N Caroline St # R00m4210, Baltimore, MD 21287-0006 | 2016-07-19 |
1114234465 | Eram Zaidi | Radiology | 3716 Bonnybridge Pl, Ellicott City, MD 21043-4115 | 2010-09-08 |
1073611901 | Martin Y Magram | Radiology | 3611 Gardenview Rd, Baltimore, MD 21208-1511 | 2006-09-21 |
1477586055 | Profesional Medical Imaging Solutions LLC | Radiology | 9900 Franklin Square Dr, Baltimore, MD 21236-5915 | 2006-07-08 |
1134128051 | Charles Edward Buckley | Radiology | 4700 Berwyn House Rd, Suite 102, College Park, MD 20740-2474 | 2005-07-21 |
1265431324 | Harvey Ziessman | Radiology | 601 N Caroline St, Baltimore, MD 21287-0006 | 2005-07-20 |
1497370597 | Marshall Kyle Mills | Radiology | 301 Hospital Dr, Glen Burnie, MD 21061-5803 | 2020-06-15 |
1033434808 | Diagnostic Imaging, LLC | Radiology | 1100 Mercantile Ln, Suite 150, Largo, MD 20774-5380 | 2010-04-05 |
1750618393 | Diagnostic Outpatient Center | Radiology | 8116 Good Luck Rd, Suite 101, Lanham, MD 20706-3502 | 2009-11-03 |
1710157706 | Barry Howard Friedman | Radiology | 201 W Preston St, Baltimore, MD 21201-2301 | 2008-03-05 |
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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.