Pediatricare, Inc.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

DO 2016 Issued in MD

Legal business name

PEDIATRICARE, INC.

Practice address

8601 Veterans Hwy
Suite 201
Millersville, MD 21108-1547

Phone

(410) 923-1505

Fax

(410) 923-6323

NPI assigned

Nov 17, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Albert Morton Gordon, M.D.

Title

President, Pediatricare, Inc.

Phone

(410) 923-1505

Specialties & licenses 1

Addresses

Other names 1

• ABC PediatriCARE Doing business as

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124191911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8601 VETERANS HWY",
            "address_2": "SUITE 201",
            "city": "MILLERSVILLE",
            "state": "MD",
            "postal_code": "211081547",
            "telephone_number": "410-923-1505",
            "fax_number": "410-923-6323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8601 VETERANS HWY",
            "address_2": "SUITE 201",
            "city": "MILLERSVILLE",
            "state": "MD",
            "postal_code": "211081547",
            "telephone_number": "410-923-1505",
            "fax_number": "410-923-6323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRICARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GORDON",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_middle_name": "MORTON",
        "authorized_official_title_or_position": "PRESIDENT, PEDIATRICARE, INC.",
        "authorized_official_telephone_number": "410-923-1505",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "DO 2016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ABC PediatriCARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Partnership Development Group, Inc.
• Jtian Patel, PHARM D, MBA
• Larissa Teal Pauly, OT
• Alicia Pearson
• Calai Tymi Pearson
• Sydney Annelise Penn
• Lieanne Marie Perez
• Shaneka Peters
• Debra M. Piccirillo
• Jemima Pierre-Jacques, DNP, CRNP, PMHNP-BC

• Pediatrics Physician in Millersville, MD
• Providers in Millersville, MD by specialty
• Pediatrics Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.