Organization Active NPI

Eastern Shore Primary Care & Wellness, LLC

  • Primary Care Clinic/Center
  • Cambridge, MD
National Provider Identifier
1073496063
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
EASTERN SHORE PRIMARY CARE & WELLNESS, LLC
Practice address
204 Cedar St Ste 101
Cambridge, MD 21613-2395
Phone
(410) 936-5500
NPI assigned
Jul 28, 2025
Last updated
Jul 28, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
EASTERN SHORE PRIMARY CARE & WELLNESS, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Authorized official

Name
Martin Melson Jr., CRNPNPI 1265978944
Title
Owner/President
Phone
(410) 936-5500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU Primary
Family Nurse Practitioner 363LF0000X NU

Addresses

Primary practice location

204 Cedar St Ste 101
Cambridge, MD 21613-2395

Mailing address

1505 S Salisbury Blvd
Salisbury, MD 21801-7128

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D2326284Eastern Shore Primary Care & Wellness204 Cedar Street Ste 101, Cambridge, MD 21613Certificate of waiverJun 30, 2027

National Provider Directory

National Provider Directory
Tax ID family
Eastern Shore Primary Care Wellness LLC2 organizations share this tax ID, including this one
Part of
Eastern Shore Primary Care Wellness LLC

Other organizations with this tax ID 1

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

Locations

204 Cedar St
Ste 101
Cambridge, MD 21613
Phone (410) 228-2170

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1753660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753660800000",
    "number": "1073496063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 S SALISBURY BLVD",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218017128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 CEDAR ST STE 101",
            "city": "CAMBRIDGE",
            "state": "MD",
            "postal_code": "216132395",
            "telephone_number": "410-936-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN SHORE PRIMARY CARE & WELLNESS, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EASTERN SHORE PRIMARY CARE & WELLNESS, LLC",
        "enumeration_date": "2025-07-28",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A",
        "authorized_official_last_name": "MELSON",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "410-936-5500",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.