Organization Active NPI

Chimax Medical Center, LLC

  • Primary Care Clinic/Center
  • Rosedale, MD
National Provider Identifier
1093984163
Registry record updated Nov 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
D0063176 Issued in MD
Legal business name
CHIMAX MEDICAL CENTER, LLC
Practice address
1232 Race Rd Ste 401
Rosedale, MD 21237-2386
Phone
(410) 686-3931
Fax
(410) 881-4572
NPI assigned
Feb 22, 2008
Last updated
Nov 11, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2021

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

Authorized official

Name
Dr. Chienyenwa Eke Nwachinemere, M.D.NPI 1316905227
Title
Provider
Phone
(410) 686-3931

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X D0063176 MD Primary

Addresses

Primary practice location

1232 Race Rd Ste 401
Rosedale, MD 21237-2386

Mailing address

1232 Race Rd Ste 401
Rosedale, MD 21237-2386
Phone (410) 686-3931

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080521000306 MD Part B Supplier - Clinic/Group Practice 1951470632 Receives reassigned benefits from 1 practitioner
Practice locations: Rosedale, MD

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
21D1082393Chimax Medical Center LLC1232 Race Road Ste 401, Baltimore, MD 21237Certificate of waiverNov 16, 2027

National Provider Directory

National Provider Directory

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": "1203638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636588800000",
    "number": "1093984163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1232 RACE RD STE 401",
            "city": "ROSEDALE",
            "state": "MD",
            "postal_code": "212372386",
            "telephone_number": "410-686-3931",
            "fax_number": "410-881-4572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1232 RACE RD STE 401",
            "city": "ROSEDALE",
            "state": "MD",
            "postal_code": "212372386",
            "telephone_number": "410-686-3931",
            "fax_number": "410-881-4572"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIMAX MEDICAL CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-22",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A",
        "authorized_official_last_name": "NWACHINEMERE",
        "authorized_official_first_name": "CHIENYENWA",
        "authorized_official_middle_name": "EKE",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "410-686-3931",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MD",
            "license": "D0063176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosedale, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.