WESTERN MARYLAND HEALTH SYSTEM BRADDOCK HOSPITAL CORPORATION , NPI 1386703718 — WMHS CARDIAC AND THORACIC SURGICAL SERVICES in CUMBERLAND (MD)

NPI 1386703718

13+ Years Experience Organization

WESTERN MARYLAND HEALTH SYSTEM BRADDOCK HOSPITAL CORPORATION

Other organization name: WMHS CARDIAC AND THORACIC SURGICAL SERVICES. Name type code: 3 - doing business as (d/b/ a) name.

12.08.2006
PROVIDER ENUMERATION DATE
06.12.2008
LAST UPDATE DATE
1386703718
NPI NUMBER

About WESTERN MARYLAND HEALTH SYSTEM BRADDOCK HOSPITAL CORPORATION

Parent organization: WESTERN MARYLAND HEALTH SYSTEM BRADDOCK HOSPITAL CORPORATION.

WESTERN MARYLAND HEALTH SYSTEM BRADDOCK HOSPITAL CORPORATION is a provider established in CUMBERLAND, MD. The NPI number of WESTERN MARYLAND HEALTH SYSTEM BRADDOCK HOSPITAL CORPORATION is 1386703718 and was assigned on 12.08.2006. The practitioners primary taxonomy code is: 207RC0000X .

Mailing address

  • City: CUMBERLAND
  • State: MD
  • Postal code: 215021873
  • Phone: 3017236365
  • Fax: 3017236277
  • Address: 902 SETON DR
  • Address 2: SUITE 204

Primary Practice Address

  • Region : CUMBERLAND, MD
  • NPI : 1386703718
  • Phone : 3017236365
  • Fax : 3017236277
  • Postalcode : 215021873
  • Address : 902 SETON DR SUITE 204

Additional identifiers

  • Identifier: 1708660
  • Code / Type : 1 - other
  • Identifier state : WV
  • Identifier issuer: MT. STATE BC BS

Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Additional identifiers # 2

  • Identifier: K936SE
  • Code / Type : 1 - other
  • Identifier state : MD
  • Identifier issuer : BC BS MD

Provider taxonomy - Internal Medicine

  • Taxonomy code: 207RC0000X

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Taxonomy group: 193400000X SINGLE SPECIALTY GROUP.

Taxonomy description: An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.

Contacts:

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  • WESTERN MARYLAND HEALTH SYSTEM BRADDOCK HOSPITAL CORPORATION
  • Address : 902 SETON DR SUITE 204
  • Region : CUMBERLAND, MD
  • NPI : 1386703718
  • Phone : 3017236365
  • Fax : 3017236277
  • Postalcode : 215021873

Authorized official :

{:AUTHORIZED_OFFICIAL_FIRST_NAME:} {:AUTHORIZED_OFFICIAL_MIDDLE_NAME:} {:AUTHORIZED_OFFICIAL_LAST_NAME:}
  • Phone : 3017231443
  • Title or position : SR. VP CFO

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address902 SETON DR
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Second Line Business Practice Location AddressSUITE 204
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameCUMBERLAND
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameMD
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code215021873
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number3017236365
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number3017236277
The fax number associated with the location address of the provider being identified.
NPI1386703718
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1207RC0000X
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Provider Enumeration Date12.08.2006
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated06.12.2008
The date that a record was last updated or changed.
Entity TypeOrganization
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Organization SubpartY
The "Is the organization a subpart?" question must be answered. If the organization is a subpart, the Parent Organization Legal Business Name (LBN) and Parent Organization Taxpayer Identification Number (TIN) fields must be completed. The Parent Organization LBN and TIN fields can only be completed if the answer to the subpart question is Yes. Many organization health care providers who apply for NPIs are not legal entities themselves but are parts of other organization health care providers that are legal entities (the "parents"). Here are three examples of organization health care providers that may be considered subparts and may apply for NPIs if so directed by their "parents": (1) The psychiatric unit in a hospital is not a legal entity but is part of the hospital (the "parent"), which is a legal entity. The legal entity must obtain an NPI. The psychiatric unit is an example of a subpart that could have its own NPI if the hospital determines that it should. (2) A group practice that is not a sole proprietorship has a main location and could have other offices in different locations, but each office is not a separate legal entity; instead, each office is part of the corporation (the "parent") which is a legal entity. The offices are examples of subparts that could have their own NPIs if the main location determines that they should. (3) A pharmacy fills prescriptions for patients whose physicians have prescribed medications for them and may also rent or sell durable medical equipment to patients whose physicians have ordered such equipment for them. Neither the pharmacy line of business nor the DME line of business represent legal entities; instead, both lines of business are part of an organization (the "parent") that is a legal entity. Each line of business represents a different Healthcare Provider Taxonomy or area of specialization that often submits its own electronic claims to health plans. The "parent"-we don"t know who the parent is in this example-must ensure that each subpart that submits its own claims to health plans has its own NPI.
Provider Organization Name (Legal Business Name)WESTERN MARYLAND HEALTH SYSTEM BRADDOCK HOSPITAL CORPORATION
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider Other Organization NameWMHS CARDIAC AND THORACIC SURGICAL SERVICES
Other name by which the organization provider is or has been known.
Provider Other Organization Name Type Code3
Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Mailing Address902 SETON DR
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Second Line Business Mailing AddressSUITE 204
The second line mailing address of the provider being identified. This data element may contain the same information as "Provider second line location address".
Provider Business Mailing Address City NameCUMBERLAND
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameMD
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code215021873
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number3017236365
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider Business Mailing Address Fax Number3017236277
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Authorized Official Last NameREPAC
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameKIMBERLY
The first name of the authorized official
Authorized Official Middle NameS.
The middle name of the authorized official
Authorized Official Title or PositionSR. VP CFO
The title or position of the authorized official
Authorized Official Name Prefix TextPROF.
Authorized Official Name Prefix Text
Authorized Official Telephone Number3017231443
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code #1207RC0000X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Internal Medicine
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Other Provider Identifier 11708660
Other Provider Identifier #1
Other Provider Identifier Type 11
  • 1 - Other
  • 5 - MEDICAID
Other Provider Identifier State 1WV
Other Provider Identifier State #1
Other Provider Identifier Issuer 1MT. STATE BC BS
Other Provider Identifier Issuer #1
Other Provider Identifier 2K936SE
Other Provider Identifier #2
Other Provider Identifier Type 21
  • 1 - Other
  • 5 - MEDICAID
Other Provider Identifier State 2MD
Other Provider Identifier State #2
Other Provider Identifier Issuer 2BC BS MD
Other Provider Identifier Issuer #2
X

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