AMBUSH LAB
NPI 1295671311
Family Medicine - Adolescent Medicine in Baltimore, MD
NPI Status: Active since April 29, 2026
Contact Information
4367 HOLLINS FERRY RD STE 1C
BALTIMORE, MD
ZIP 21227
Phone: (410) 707-5947
Fax: (410) 707-5947
- Organization
- Family Medicine
- Adolescent Medicine
- CLIA Number: 45D2313953
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 07-07-2027
About AMBUSH LAB
This page provides the complete NPI Profile along with additional information for Ambush Lab, a primary care provider established in Baltimore, Maryland operating as a Family Medicine, focusing in adolescent medicine . The healthcare provider is registered in the NPI registry with number 1295671311 assigned on April 2026. The practitioner's primary taxonomy code is 207QA0000X. The provider is registered as an organization and their NPI record was last updated April 2026. Ambush Lab operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Jacqueline Ebony Ambush Dnp (Owner)
- NPI
- 1295671311
- Provider Name
- AMBUSH LAB
- Entity Type
- Organization
- Location Address
- 4367 HOLLINS FERRY RD STE 1C BALTIMORE, MD 21227
- Location Phone
- (410) 707-5947
- Location Fax
- (410) 707-5947
- Mailing Address
- 4367 HOLLINS FERRY RD STE 1C BALTIMORE, MD 21227
- Mailing Phone
- (410) 707-5947
- Mailing Fax
- (410) 707-5947
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- Yes
- Enumeration Date
- 04-29-2026
- Last Update Date
- 04-29-2026
- Code Navigator
A primary care provider (PCP) like Ambush Lab sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Secondary Locations
- 5252 Hollister St Ste 203C
Houston, TX 77040
(346) 678-4442
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Family Medicine Adolescent Medicine
- Taxonomy Code
- 207QA0000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs.
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 45D2313953
- Facility Type
- Physician Office
- Certificate Effective Date
- July 08, 2025
- Certificate Expiration Date
- July 07, 2027
- Laboratory Director
- DR. MERRILL HINES
- Certificate Type
- Certificate of Accreditation
- Certificate Type Description
- This is a CLIA certificate is issued to Ambush Lab on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1295671311, we treat the final digit (1) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 59. The final step is to find the difference between that total and the next multiple of ten (60 - 59 = 1).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 59 is 60. The difference is the calculated check digit.
Other Providers at the Same Location
The following 1 provider is registered at the same or a nearby location.
HALETHORPE, MD 21227
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1295671311, enumerated as an "organization" on April 29, 2026.
The provider is located at 4367 HOLLINS FERRY RD STE 1C BALTIMORE, MD 21227 and the phone number is (410) 707-5947.
Family Medicine with taxonomy code 207QA0000X and a focus in Adolescent Medicine.
