Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

Shady Grove Ambulatory Surgery Center,LLC

Ambulatory Surgical Clinic/Center in Gaithersburg, MD · enumerated 2006 · authorized official Ronald Footer, Medical Director.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1558463257

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Registry record

Entity type Organization (Type 2)

Legal business name Shady Grove Ambulatory Surgery Center,LLC

Practice address 16220 S Frederick Ave, Suite 427, Gaithersburg, MD, 20877

Phone (301) 948-2995

Fax (301) 948-6056

Enumeration date Sep 2, 2006

Last updated in NPPES Aug 25, 2009

Taxonomy & classification

261QA1903X Ambulatory Surgical Clinic/Center Ambulatory Health Care Facilities · License A1135 (MD) Primary

Authorized official

Name Ronald Footer

Title Medical Director

Phone (301) 948-2995

Other identifiers

Identifier	Type	State	Issuer
A1135	Other	MD	MARYLAND STATE LICENSE #

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2009-08-25. Verify at npiregistry.cms.hhs.gov.

Where is Shady Grove Ambulatory Surgery Center,LLC located?

The practice location on file with NPPES is in Gaithersburg, MD.

Providers at this address

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2009-08-25.