MATCLINIC PHYSICIANS PRACTICE GROUP LLC (NPI# 1821647934) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821647934 |
| Entity Type | Organization |
| Organization Name | MATCLINIC PHYSICIANS PRACTICE GROUP LLC |
| Practice Address |
107 Ridgely Ave Ste 12 Annapolis MD 21401-1417 |
| Mailing Address |
503 Albemarle St Baltimore MD 21202-4304 |
| Practice Telephone | 4102200780 |
| Practice Fax Number | 4108620150 |
| Mailing Telephone | 4102200780 |
| Mailing Fax Number | 4108620150 |
| Enumeration Date | 2019-09-11 |
| Last Update Date | 2020-08-07 |
| Authorized Official Name | DANIEL RECK (MANAGER) |
| Authorized Official Telephone | 4102200780 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR0405X |
Clinic/Center Specialization: Rehabilitation, Substance Use Disorder |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | 265074602 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548825813 | Matclinic Physicians Practice Group LLC | Counselor | 40 York Rd Ste 201, Towson, MD 21204-5243 | 2019-05-02 |
| 1356801534 | Matclinic Physicians Practice Group LLC | Internal Medicine | 107 Ridgely Ave Ste 12, Annapolis, MD 21401-1417 | 2019-03-22 |
| 1194217091 | Matclinic Physicians Practice Group LLC | Counselor | 601 7th St Ste 304, Laurel, MD 20707-4011 | 2018-06-06 |
| 1699385336 | Matclinic Physicians Practice Group LLC | Clinic/Center | 40 York Rd Ste 201, Towson, MD 21204-5243 | 2020-08-07 |
| 1417567157 | Matclinic Physicians Practice Group LLC | Clinic/Center | 601 7th St Ste 304, Laurel, MD 20707-4011 | 2020-08-07 |
| 1336759075 | Matclinic Physicians Practice Group LLC | Clinic/Center | 40 S Dundalk Ave Ste 400, Dundalk, MD 21222-4273 | 2020-08-07 |
| 1316557051 | Matclinic Physicians Practice Group LLC | Clinic/Center | 107 Ridgely Ave Ste 12, Annapolis, MD 21401-1417 | 2020-08-07 |
| 1841840808 | Matclinic Physicians Practice Group LLC | Community/Behavioral Health | 107 Ridgely Ave Ste 12, Annapolis, MD 21401-1417 | 2019-09-12 |
| 1669022620 | Matclinic Physicians Practice Group LLC | Community/Behavioral Health | 40 York Rd Ste 201, Towson, MD 21204-5243 | 2019-09-12 |
| 1750930863 | Matclinic Physicians Practice Group LLC | Clinic/Center | 601 7th St Ste 304, Laurel, MD 20707-4011 | 2019-09-11 |
| Street Address |
107 RIDGELY AVE STE 12 |
| City | ANNAPOLIS |
| State | MD |
| Zip Code | 21401-1417 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356801534 | Matclinic Physicians Practice Group LLC | Internal Medicine | 107 Ridgely Ave Ste 12, Annapolis, MD 21401-1417 | 2019-03-22 |
| 1316557051 | Matclinic Physicians Practice Group LLC | Clinic/Center | 107 Ridgely Ave Ste 12, Annapolis, MD 21401-1417 | 2020-08-07 |
| 1841840808 | Matclinic Physicians Practice Group LLC | Community/Behavioral Health | 107 Ridgely Ave Ste 12, Annapolis, MD 21401-1417 | 2019-09-12 |
| 1174175632 | Matclinic Physicians Practice Group LLC | Counselor | 107 Ridgely Ave Ste 12, Annapolis, MD 21401-1417 | 2019-07-15 |
| 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 |
| Find all providers in zip 21401 | ||||
| Taxonomy Code | 261QR0405X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rehabilitation, Substance Use Disorder |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366508004 | Anne Arundel General Treatment Services, Inc | Clinic/Center | 2620 Riva Rd, Annapolis, MD 21401-7305 | 2006-12-28 |
| 1912396961 | Anne Arundel General Treatment Services, Inc | Clinic/Center | 2620 Riva Rd, Annapolis, MD 21401-7305 | 2015-01-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043817075 | Maryland Community Health Initiatives, Inc. | Clinic/Center | 2648 Guilford Ave Apt 1fl, Baltimore, MD 21218-4611 | 2020-10-02 |
| 1851998892 | Maryland Community Health Initiatives, Inc. | Clinic/Center | 2648 Guilford Ave Apt 2fl, Baltimore, MD 21218-4611 | 2020-10-02 |
| 1801403324 | Maryland Community Health Initiatives, Inc. | Clinic/Center | 328 E 26th St, Baltimore, MD 21218-4702 | 2020-09-29 |
| 1275148975 | Hel Recovery Center | Clinic/Center | 1900 N Howard St Fl 2, Baltimore, MD 21218-5909 | 2020-09-10 |
| 1497365654 | Inspiring Change Mental Health Services, LLC. | Clinic/Center | 4654 York Rd Ste 1, Baltimore, MD 21212-4726 | 2020-08-03 |
| 1174132518 | Sabinas House LLC | Clinic/Center | 3103 Mareco Ave, Baltimore, MD 21213-1619 | 2020-07-30 |
| 1134738909 | Sabinas House LLC | Clinic/Center | 2224 Dukeland St, Baltimore, MD 21216-2812 | 2020-07-28 |
| 1881203792 | Sabinas House LLC | Clinic/Center | 3325 Shannon Dr, Baltimore, MD 21213-1823 | 2020-07-27 |
| 1356950265 | Sabinas House LLC | Clinic/Center | 616 Wildwood Pkwy, Baltimore, MD 21229-1810 | 2020-07-27 |
| 1598374407 | Sabinas House LLC | Clinic/Center | 605 Springfield Ave, Baltimore, MD 21212-4832 | 2020-07-27 |
| Find all providers with the same taxonomy | ||||
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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.