WESTERN MARYLAND HEALTH CARE CORPORATION
NPI 1053727065
Clinic/Center - Federally Qualified Health Center (FQHC) in Grantsville, MD
About Western Maryland Health Care Corporation NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
WESTERN MARYLAND HEALTH CARE CORPORATION (NPI 1053727065), doing business as Mountain Laurel Medical Center, is a healthcare organization registered as a federally qualified health center (fqhc) in Grantsville, Maryland and active in the NPI registry since July 2014. The organization holds 4 active CLIA laboratory certificates and lists Michelle K Dixon, Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Names 1
Other Identifiers 4
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Western Maryland Health Care Corporation is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by March 31, 2027
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
26Medicare enrollment records show 26 clinicians reassign Medicare billing to Western Maryland Health Care Corporation, which bills Medicare for the services they deliver. Of these, 4 practice at this address. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 6
Nearest to this location (20)
See all 26Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA 4
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 21D1056602
Western Maryland Healthcare Corporation Dba Mounta · Oakland, MDCertificate for Provider-Performed Microscopy Procedures (PPMP) 21D2086541
Western Maryland Healthcare Corporation Dba Mounta · Grantsville, MDCertificate of Waiver 51D2071429
Western Maryland Healthcare Corporation Dba Mountain Laurel Medical Center · Bruceton Mills, WVCertificate for Provider-Performed Microscopy Procedures (PPMP) 21D2165805
Western Maryland Healthcare Corporation Dba Mounta · Westernport, MDFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Western Maryland Health Care Corporation's NPI number?
The NPI number for Western Maryland Health Care Corporation is 1053727065. It was assigned to this organization in the NPPES registry on July 10, 2014. The provider is doing business as Mountain Laurel Medical Center.
Where is Western Maryland Health Care Corporation located?
Western Maryland Health Care Corporation is located at 28 Hershberger Ln, Grantsville, MD 21536. The listed phone number is (301) 895-5107.
What is Western Maryland Health Care Corporation's specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.
Is Western Maryland Health Care Corporation enrolled in Medicare?
Yes. Western Maryland Health Care Corporation is registered in the Medicare PECOS enrollment system.
When is Western Maryland Health Care Corporation's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Part A enrollment for this organization (Maryland, Federally Qualified Health Center (FQHC)) is due for revalidation by March 31, 2027. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Western Maryland Health Care Corporation?
According to the CMS Revalidation Reassignment List (October 2026 release), 26 clinicians in 6 Medicare specialties reassign their Medicare billing to Western Maryland Health Care Corporation. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (12), Family Practice (6) and Clinical Social Worker (5). Of these, 4 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Western Maryland Health Care Corporation hold CLIA laboratory certificates?
Yes. 4 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.
What insurance does Western Maryland Health Care Corporation accept?
Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Buckeye Health Plan, CareSource and Highmark Blue Cross Blue Shield West Virginia list Western Maryland Health Care Corporation as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Western Maryland Health Care Corporation was last updated on March 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Western Maryland Health Care Corporation · NPI 1053727065
Federally Qualified Health Center (FQHC) organization in Grantsville, Maryland. Organization record, active in the CMS NPPES registry since July 10, 2014.
## Identity
- **NPI:** 1053727065 (Entity type: Organization)
- **Enumerated:** July 10, 2014
- **Primary specialty:** Clinic/Center - Federally Qualified Health Center (FQHC) · taxonomy 261QF0400X
- **Also known as:** Mountain Laurel Medical Center (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Michelle Dixon, CEO
## Practice location
- **Address:** 28 HERSHBERGER LN, Grantsville, MD 21536-1172
- **Phone:** (301) 895-5107 · **Fax:** (833) 448-0359
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** March 31, 2027 (Part A, Maryland, Federally Qualified Health Center (FQHC)) · CMS Revalidation Due Date List, October 2026 release
- **Clinicians billing through this organization:** 26 clinicians in 6 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (12), Family Practice (6), Clinical Social Worker (5); 4 practice at this address; [full list](https://npiprofile.com/npi/1053727065/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** March 4, 2026
- **Other identifiers:** Medicaid 3810007182 (WV); Medicaid 103007026001 (PA); Medicaid 410467600 (MD); and 1 more
- **CLIA laboratory certificates:** 4 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1053727065) · Data from the CMS NPPES public registry.