Organization Active NPI

The Pediatric Center LLC

  • Pediatrics Physician
  • Columbia, MD
National Provider Identifier
1083696041
Registry record updated Sep 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
THE PEDIATRIC CENTER LLC
Practice address
5900 Waterloo Rd Ste 110
Columbia, MD 21045-2636
Phone
(443) 451-1600
Fax
(443) 451-1619
NPI assigned
Nov 16, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2016

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

Authorized official

Name
Dr. James A Kopper
Title
Medical Doctor
Phone
(443) 451-1600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

5900 Waterloo Rd Ste 110
Columbia, MD 21045-2636

Mailing address

5900 Waterloo Road,
Suite 110
Columbia, MD 21045-4147
Phone (443) 451-1600

Other identifiers 1

IdentifierTypeStateIssuer
971721800MedicaidMD

National Provider Directory

National Provider Directory

Locations

700 Geipe Rd
Ste 210
Catonsville, MD 21228
Phone (443) 451-1600

5900 Waterloo Rd
Ste 110
Columbia, MD 21045
Phone (443) 451-1600

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1132099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473811200000",
    "number": "1083696041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 WATERLOO ROAD,",
            "address_2": "SUITE 110",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210454147",
            "telephone_number": "443-451-1600",
            "fax_number": "443-451-1619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 WATERLOO RD STE 110",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452636",
            "telephone_number": "443-451-1600",
            "fax_number": "443-451-1619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PEDIATRIC CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-16",
        "last_updated": "2016-09-14",
        "status": "A",
        "authorized_official_last_name": "KOPPER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MEDICAL DOCTOR",
        "authorized_official_telephone_number": "443-451-1600",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "971721800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2016; 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.