Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 402 Marvel Ct, Easton, Maryland |
Authorized Official Name and Position | Amy Marie Nieman (DIRECTOR) |
Authorized Official Contact | 5135441003 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
4600 Montgomery Rd Ste 400 Cincinnati OH 45212-2600 Ph: (833) 510-4357 | 402 Marvel Ct Easton MD 21601-4052 Ph: (833) 510-4357 |
NPI Number | 1871287888 |
---|---|
Provider Enumeration Date | 06/05/2023 |
Last Update Date | 09/25/2024 |
Medicare PECOS PAC ID | 7911377676 |
---|---|
Medicare Enrollment ID | O20231023003453 |
Identifier | Type | State | Issuer |
---|---|---|---|
1871287888 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
261QR0405X | Clinic/center - Rehabilitation, Substance Use Disorder | (* (Not Available)) | Primary |
Provider Name | Sughanda Khanna |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1326018060 PECOS PAC ID: 7315926532 Enrollment ID: I20040720000253 |
Provider Name | Jeannette C Quigley |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1386817492 PECOS PAC ID: 1759430564 Enrollment ID: I20090528000208 |
Provider Name | Irish Jones |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1366909442 PECOS PAC ID: 3476987645 Enrollment ID: I20191220001189 |
Provider Name | Heidi Mcneeley |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1932976370 PECOS PAC ID: 4082064266 Enrollment ID: I20231229002738 |
Provider Name | Jennifer Messix |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1790534279 PECOS PAC ID: 9931646346 Enrollment ID: I20240802002499 |
Eastern Shore Foot And Ankle Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8579 Commerce Dr, Suite 100, Easton, MD 21601 Phone: 410-822-0645 Fax: 410-763-8744 | |
University Of Maryland Community Medical Group, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 500 Cadmus Ln Ste 210, Easton, MD 21601 Phone: 410-822-8550 | |
University Of Maryland Community Medical Group, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5 Martin Ct, Easton, MD 21601 Phone: 410-820-9823 | |
Choptank Community Health System Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 215 Bay St, Easton, MD 21601 Phone: 410-479-4306 Fax: 410-479-1714 | |
University Of Maryland Community Medical Group, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 510 Idlewild Ave, Easton, MD 21601 Phone: 410-820-8226 |