NPIMap

Organization Active NPI

Prince George's County Health Department

  • Public Health or Welfare Agency
  • Largo, MD
National Provider Identifier
1023091915
Registry record updated Mar 1, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
PRINCE GEORGE'S COUNTY HEALTH DEPARTMENT
Practice address
1701 McCormick Dr
Largo, MD 20774-5329
Phone
(301) 883-7819
Fax
(301) 883-7890
NPI assigned
Nov 23, 2005
Last updated
Mar 1, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
PRINCE GEORGE'S COUNTY HEALTH DEPARTMENTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 1, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Gwendolyn Clerkly
Title
Health Officer
Phone
(301) 883-7819

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X NU Primary

Addresses

Primary practice location

1701 McCormick Dr
Largo, MD 20774-5329

Mailing address

1701 McCormick Dr
Largo, MD 20774-5329
Phone (301) 883-7819

Other identifiers 18

IdentifierTypeStateIssuer
70443MedicaidMD
70450MedicaidMD
70452MedicaidMD
00343MedicaidMD
23484MedicaidMD
70448MedicaidMD
70465MedicaidMD
72015MedicaidMD
70446MedicaidMD
70482MedicaidMD
73008MedicaidMD
75012MedicaidMD
44915MedicaidMD
45975MedicaidMD
70480MedicaidMD
70451MedicaidMD
70476MedicaidMD
09841MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
Prince Georges County Health Department48 organizations share this tax ID, including this one
Part of
Prince Georges County Health Department

Other organizations with this tax ID 47

Organizations that report the same tax identification number in the National Provider Directory.

View all 47

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519862400000",
    "number": "1023091915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 MCCORMICK DR",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207745329",
            "telephone_number": "301-883-7819",
            "fax_number": "301-883-7890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 MCCORMICK DR",
            "city": "LARGO",
            "state": "MD",
            "postal_code": "207745329",
            "telephone_number": "301-883-7819",
            "fax_number": "301-883-7890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRINCE GEORGE'S COUNTY HEALTH DEPARTMENT",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRINCE GEORGE'S COUNTY HEALTH DEPARTMENT",
        "enumeration_date": "2005-11-23",
        "last_updated": "2018-03-01",
        "status": "A",
        "authorized_official_last_name": "CLERKLY",
        "authorized_official_first_name": "GWENDOLYN",
        "authorized_official_title_or_position": "HEALTH OFFICER",
        "authorized_official_telephone_number": "301-883-7819"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "70443",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "70450",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "70452",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00343",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "23484",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "70448",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "70465",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "72015",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "70446",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "70482",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "73008",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "75012",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "44915",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "45975",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "70480",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "70451",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "70476",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09841",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Largo, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.