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UNIVERSITY OF MARYLAND COMMUNITY MEDICAL GROUP, INC.
NPI 1104676170
Family Medicine in Queenstown, MD

Active since March 25, 2024CLIA Certified · 4 labs
125 SHOREWAY DR STE 210, QUEENSTOWN, MD 21658(410) 820-0560 Get Directions Write a Review

NPPES record last updated: March 25, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About University Of Maryland Community Medical Group, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

UNIVERSITY OF MARYLAND COMMUNITY MEDICAL GROUP, INC. (NPI 1104676170) is a healthcare organization registered as a family medicine in Queenstown, Maryland and active in the NPI registry since March 2024. The organization holds 4 active CLIA laboratory certificates and lists Paul Stephen Nicholson, Ao, as its authorized official.

NPPES Registry Identity

NPI1104676170
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameUNIVERSITY OF MARYLAND COMMUNITY MEDICAL GROUP, INC.
Location Address125 SHOREWAY DR STE 210Queenstown, MD 21658-1682
Mailing Address900 Elkridge Landing Rd Fl 2Linthicum, MD 21090-2924
Phone(410) 820-0560
Organization SubpartNo
Authorized OfficialPaul Stephen NicholsonAo · (410) 337-1602
Enumeration DateMarch 25, 2024
NPPES CertifiedMarch 24, 2024
✔ NPI 1104676170 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
125 SHOREWAY DR STE 210, Queenstown, MD 21658
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 5

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 21D2004905

University Of Maryland Community Medical Group · Easton, MD
Active · expires Mar 15, 2028
CLIA Number21D2004905
Laboratory TypePhysician Office
Certificate Effective DateMarch 16, 2026
Certificate Expiration DateMarch 15, 2028
Laboratory DirectorChristopher L. Runz
Laboratory Phone(410) 820-0560
Laboratory LocationUniversity Of Maryland Community Medical Group490 Cadmus Lane Suite 104, Easton, MD 21601
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 21D2004486

University Of Maryland Community Medical Group · Queenstown, MD
Active · expires Nov 13, 2027
CLIA Number21D2004486
Laboratory TypePhysician Office
Certificate Effective DateNovember 14, 2025
Certificate Expiration DateNovember 13, 2027
Laboratory DirectorDr. Christopher Runz
Laboratory Phone(410) 820-0560
Laboratory LocationUniversity Of Maryland Community Medical Group125 Shore Way Dr Suite 210, Queenstown, MD 21658
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 21D2004491

University Of Maryland Community Medical Group · Cambridge, MD
Active · expires Jun 26, 2027
CLIA Number21D2004491
Laboratory TypePractitioner Other
Certificate Effective DateJune 27, 2025
Certificate Expiration DateJune 26, 2027
Laboratory DirectorDr. Christopher L. Runz
Laboratory Phone(410) 820-0560
Laboratory LocationUniversity Of Maryland Community Medical Group713 Cambridge Marketplace Blvd Suite 2-700, Cambridge, MD 21613
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 21D2174041

University Of MD Community Medical Group · Denton, MD
Active · expires Oct 22, 2027
CLIA Number21D2174041
Laboratory TypePhysician Office
Certificate Effective DateOctober 23, 2025
Certificate Expiration DateOctober 22, 2027
Laboratory DirectorRichard Cespedes
Laboratory Phone(410) 820-0560
Laboratory LocationUniversity Of MD Community Medical Group1140 Blades Farm Rd, Denton, MD 21629
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 21D2045390

University Of Maryland Community Med Grp · Chestertown, MD
Expired · Aug 12, 2026
CLIA Number21D2045390
Laboratory TypePhysician Office
Certificate Effective DateAugust 13, 2024
Certificate Expiration DateAugust 12, 2026
Laboratory DirectorDr. Christopher Parry
Laboratory Phone(410) 820-0560
Laboratory LocationUniversity Of Maryland Community Med Grp100 Brown St #2-300, Chestertown, MD 21620
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

UNIVERSITY OF MARYLAND COMMUNITY MEDICAL GROUP, INC.
Family Medicine
125 SHOREWAY DR STE 210
QUEENSTOWN, MD 21658
Queen Anne's County (410) 820-0560
UNIVERSITY OF MARYLAND COMMUNITY MEDICAL GROUP, INC.
Family Medicine
125 SHOREWAY DR STE 210
QUEENSTOWN, MD 21658
Queen Anne's County (410) 770-5250
UNIVERSITY OF MARYLAND COMMUNITY MEDICAL GROUP, INC.
Family Medicine
125 SHOREWAY DR STE 210
QUEENSTOWN, MD 21658
Queen Anne's County (410) 770-5250

Frequently 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 University Of Maryland Community Medical Group, Inc.'s NPI number?

The NPI number for University Of Maryland Community Medical Group, Inc. is 1104676170. It was assigned to this organization in the NPPES registry on March 25, 2024.

Where is University Of Maryland Community Medical Group, Inc. located?

University Of Maryland Community Medical Group, Inc. is located at 125 Shoreway Dr Ste 210, Queenstown, MD 21658. The listed phone number is (410) 820-0560.

What is University Of Maryland Community Medical Group, Inc.'s specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does University Of Maryland Community Medical Group, Inc. 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.

When was this NPI record last updated?

The NPPES record for University Of Maryland Community Medical Group, Inc. was last updated on March 25, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years 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.