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BRADDOCK MEDICAL GROUP P.A.
NPI 1710980081
Clinic/Center - Primary Care in Cumberland, MD

Active since May 31, 2005
912 SETON DR, CUMBERLAND, MD 21502(301) 722-3111(301) 722-5135 Get Directions Write a Review

NPPES record last updated: March 21, 2023. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Braddock Medical Group P.a. NPPES

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

BRADDOCK MEDICAL GROUP P.A. (NPI 1710980081) is a healthcare organization registered as a primary care in Cumberland, Maryland and active in the NPI registry since May 2005. The organization maintains a secondary practice location in Cumberland and lists Paul Taylor Livengood, Owner, as its authorized official.

NPPES Registry Identity

NPI1710980081
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameBRADDOCK MEDICAL GROUP P.A.
Location Address912 SETON DRCumberland, MD 21502-1818
Mailing Address912 Seton DrCumberland, MD 21502-1818 · (301) 722-3111 · Fax (301) 722-5135
Phone(301) 722-3111
Fax(301) 722-5135
Organization SubpartNo
Authorized OfficialPaul Taylor LivengoodOwner · (301) 722-3111
Enumeration DateMay 31, 2005
Last NPPES UpdateMarch 21, 2023
NPPES CertifiedMarch 21, 2023
✔ NPI 1710980081 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
Also ListedContractorTaxonomy 171W00000X
912 SETON DR, Cumberland, MD 21502
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Secondary Practice Location 1

Location 1912 Seton DrCumberland, MD 21502-1818 · Phone (301) 722-3111 ext. 107 · Fax (301) 722-5135

Other Identifiers 5

Medicaid00874296PA
Medicaid910291400MD
Other6216720003Cigna
OtherH529Medicare Group Id
Medicaid0011509000WV

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 6

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

BRADDOCK MEDICAL GROUP
Clinical Medical Laboratory
912 SETON DR
CUMBERLAND, MD 21502
Allegany County (301) 722-3111
DR. GREGG C DONALDSON MD
Internal Medicine
912 SETON DR
CUMBERLAND, MD 21502
Allegany County (301) 722-3111
DR. PAUL TAYLOR LIVENGOOD MD
Family Medicine
912 SETON DR
CUMBERLAND, MD 21502
Allegany County (301) 722-3111
LISA W JENKINS CRNP
Nurse Practitioner (Family)
912 SETON DR
CUMBERLAND, MD 21502
Allegany County (301) 722-3111
DR. THOMAS E CHAPPELL MD
Internal Medicine
912 SETON DR
CUMBERLAND, MD 21502
Allegany County (301) 722-3111
LUCINDA RUTH EVERETT CRNP
Nurse Practitioner (Family)
912 SETON DR
CUMBERLAND, MD 21502
Allegany County (301) 722-3111

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 Braddock Medical Group P.A.'s NPI number?

The NPI number for Braddock Medical Group P.A. is 1710980081. It was assigned to this organization in the NPPES registry on May 31, 2005.

Where is Braddock Medical Group P.A. located?

Braddock Medical Group P.A. is located at 912 Seton Dr, Cumberland, MD 21502. The listed phone number is (301) 722-3111.

What is Braddock Medical Group P.A.'s specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

When was this NPI record last updated?

The NPPES record for Braddock Medical Group P.A. was last updated on March 21, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.