Chesapeake Care Resources, Inc.

Primary specialty

Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X

Legal business name

CHESAPEAKE CARE RESOURCES, INC.

Practice address

80 Marysville Rd
North East, MD 21901-2317

Phone

(410) 287-5040

NPI assigned

Mar 31, 2021

Organization subpart

No

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

Authorized official

Name

Janet Kelly

Title

President

Phone

(410) 287-5040

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1617148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617148800000",
    "number": "1104404110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 MARYSVILLE RD",
            "city": "NORTH EAST",
            "state": "MD",
            "postal_code": "219012317",
            "telephone_number": "410-287-5040",
            "fax_number": "410-287-9511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 MARYSVILLE RD",
            "city": "NORTH EAST",
            "state": "MD",
            "postal_code": "219012317",
            "telephone_number": "410-287-5040"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 Marysville Rd",
            "address_purpose": "LOCATION",
            "city": "North East",
            "state": "MD",
            "postal_code": "219012317",
            "country_code": "US",
            "telephone_number": "410-287-5040",
            "fax_number": "410-287-9511",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "80 Marysville Rd",
            "address_purpose": "LOCATION",
            "city": "North East",
            "state": "MD",
            "postal_code": "219012317",
            "country_code": "US",
            "telephone_number": "410-287-5040",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "80 Marysville Rd",
            "address_purpose": "LOCATION",
            "city": "North East",
            "state": "MD",
            "postal_code": "219012317",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "80 Marysville Rd",
            "address_purpose": "LOCATION",
            "city": "North East",
            "state": "MD",
            "postal_code": "219012317",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "80 Marysville Rd",
            "address_purpose": "LOCATION",
            "city": "North East",
            "state": "MD",
            "postal_code": "219012317",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "80 Marysville Rd",
            "address_purpose": "LOCATION",
            "city": "North East",
            "state": "MD",
            "postal_code": "219012317",
            "country_code": "US",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CHESAPEAKE CARE RESOURCES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-31",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-09",
        "status": "A",
        "authorized_official_last_name": "KELLY",
        "authorized_official_first_name": "JANET",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-287-5040"
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "103TR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00000045",
            "state": "DE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00000043",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; 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.