Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Shady Grove Ambulatory Surgery Center, LLC

Organization Ambulatory Surgical Clinic/Center · NPI 1558463257

Shady Grove Ambulatory Surgery Center, LLC is an Ambulatory Surgical Clinic/Center in Gaithersburg, Maryland. Licensed in Maryland. Registered with an NPI since 2006.

Licensed in
MD
In the registry since
2006
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

16220 S Frederick Ave Ste 427
Gaithersburg, MD 20877-4039
Phone: (301) 948-2995
Fax: (301) 948-6056
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Ambulatory Surgical Clinic/Center (primary) Taxonomy 261QA1903X · Licence A1135 (MD)

Record details

NPI number1558463257
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Ronald Footer — Medical Director · (301) 948-2995
NPI enumeratedSeptember 2, 2006
Last updated in NPPESAugust 25, 2009
Mailing address16220 S Frederick Ave, Suite 427, Gaithersburg, MD 20877-4039

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