SOUTH MOUNTAIN FAMILY PRACTICE LLC (NPI# 1487844593) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487844593 |
| Entity Type | Organization |
| Organization Name | SOUTH MOUNTAIN FAMILY PRACTICE LLC |
| Practice Address |
9 Saint Paul St Boonsboro MD 21713-1334 |
| Practice Telephone | 3014320623 |
| Practice Fax Number | 3014320624 |
| Mailing Telephone | 3014320623 |
| Mailing Fax Number | 3014320624 |
| Enumeration Date | 2007-07-26 |
| Last Update Date | 2011-06-29 |
| Authorized Official Name | DR. WILLIAM F BODENHEIMER III (OWNER) |
| Authorized Official Telephone | 3014320623 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | D0056826 | MD | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 864001700 | 05 |
| Street Address |
9 SAINT PAUL ST |
| City | BOONSBORO |
| State | MD |
| Zip Code | 21713-1334 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538120373 | Maria Teresa Elizalde | Nurse Practitioner | 9 Saint Paul St, 2nd Floor, Boonsboro, MD 21713-1334 | 2006-03-31 |
| 1083012439 | Rebecca Targoff | Nurse Practitioner | 9 Saint Paul St, 2nd Floor, Boonsboro, MD 21713-1334 | 2014-12-17 |
| 1831536242 | Kelly Ann Flemming | Physical Therapy Assistant | 9 Saint Paul St, 3rd Floor, Boonsboro, MD 21713-1334 | 2013-05-24 |
| 1841207420 | Life Fitness Physical Therapy of Boonsboro | Physical Therapist | 9 Saint Paul St, 3rd Floor, Boonsboro, MD 21713-1334 | 2006-08-03 |
| 1427010354 | William Franklin Bodenheimer IIi | Family Medicine | 9 Saint Paul St, Boonsboro, MD 21713-1334 | 2006-04-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083241210 | Fahrney-keedy Memorial Home, Inc. | Clinic/Center | 21 Mountain View Drive, Boonsboro, MD 21713 | 2020-03-26 |
| 1538687157 | Aaron M. Smith | Physical Therapy Assistant | 141 S. Main Street, Boonsboro, MD 21713 | 2017-09-04 |
| 1659739720 | San Mar Children's Home | Social Worker | 8504 Mapleville Road, Boonsboro, MD 21713 | 2016-02-04 |
| 1114351624 | Amanda Lindsay Wegh | Physical Therapy Assistant | 141 S Main St., Boonsboro, MD 21713 | 2013-09-03 |
| 1932388493 | South Mountain Community Health LLC | Nurse Practitioner | 9 Saint Paul St Ste 3, Boonsboro, MD 21713 | 2007-10-31 |
| 1679796718 | Vivian S Sewell | Counselor | 24 N. Main Street, Boonsboro, MD 21713 | 2007-04-10 |
| 1023164829 | Melissa Ann Phillips | Social Worker | 8504 Mapleville Rd, Boonsboro, MD 21713 | 2007-01-25 |
| 1801182597 | Kate M Rhodes | Physical Therapist | 141 S Main St, Suite 205, Boonsboro, MD 21713 | 2011-06-22 |
| 1689703712 | Gordon D Bekedam | Dentist | 112 N Main St, Boonsboro, MD 21713 | 2007-03-05 |
| 1053813634 | Daniel C. Mceowen Dds, PC | Clinic/Center | 112 N Main St Ste 1, Boonsboro, MD 21713-1063 | 2018-02-28 |
| Find all providers in zip 21713 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
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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.