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PORT RECOVERY PHYSICIANS CARE LLC
NPI 1124470356
Internal Medicine in Nottingham, MD

Active since July 12, 2016
8615 RIDGELYS CHOICE DR STE 205, NOTTINGHAM, MD 21236(443) 869-4909(443) 869-4928 Get Directions Write a Review

NPPES record last updated: May 30, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 30, 2025, Nov 15, 2018, Nov 2, 2018 and 4 more (7 updates tracked since 2016).

About Port Recovery Physicians Care Llc NPPES

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

PORT RECOVERY PHYSICIANS CARE LLC (NPI 1124470356) is a healthcare organization registered as an internal medicine in Nottingham, Maryland and active in the NPI registry since July 2016. The organization lists Joanne Granruth, Owner, as its authorized official.

NPPES Registry Identity

NPI1124470356
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NamePORT RECOVERY PHYSICIANS CARE LLC
Location Address8615 RIDGELYS CHOICE DR STE 205Nottingham, MD 21236-3028
Mailing Address8615 Ridgelys Choice Dr Ste 205Nottingham, MD 21236-3028 · (443) 534-8735 · Fax (410) 534-8737
Phone(443) 869-4909
Fax(443) 869-4928
Organization SubpartNo
Authorized OfficialJoanne GranruthOwner · (410) 534-8735
Enumeration DateJuly 12, 2016
Last NPPES UpdateMay 30, 20257 updates tracked since enumeration
NPPES CertifiedMay 30, 2025
✔ NPI 1124470356 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
8615 RIDGELYS CHOICE DR STE 205, Nottingham, MD 21236
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Other Identifiers 2

Medicaid886200100MD
OtherCP64-0000MD · Carefirst Bluecross Bluesheild

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

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Port Recovery Physicians Care Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Port Recovery Physicians Care LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 2 within 10 miles. They are listed nearest first.

Clinicians, nearest first (3)

Elaine Cook, CRNP
Nurse Practitioner
NPI 1174504047
8615 RIDGELYS CHOICE DR
Nottingham, MD 21236
(410) 766-8009
✔ PECOSSame address
Terri Nicholson
Nurse Practitioner
NPI 1144659400
405 N PACA ST
Baltimore, MD 21201
(410) 779-9609
✔ PECOS✔ Accepts Medicare9.6 mi
Randal Steele, D.O.
Family Practice
NPI 1811969835
1115 MAIN ST
Darlington, MD 21034
(410) 457-4771
✔ PECOS✔ Accepts Medicare23 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Port Recovery Physicians Care LLC's NPI number?

The NPI number for Port Recovery Physicians Care LLC is 1124470356. It was assigned to this organization in the NPPES registry on July 12, 2016.

Where is Port Recovery Physicians Care LLC located?

Port Recovery Physicians Care LLC is located at 8615 Ridgelys Choice Dr Ste 205, Nottingham, MD 21236. The listed phone number is (443) 869-4909.

What is Port Recovery Physicians Care LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Port Recovery Physicians Care LLC enrolled in Medicare?

Yes. Port Recovery Physicians Care LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Port Recovery Physicians Care LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians reassign their Medicare billing to Port Recovery Physicians Care LLC, in Family Practice and Nurse Practitioner. 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. Of these, 1 practice at this address and 2 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Port Recovery Physicians Care LLC was last updated on May 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.