Organization Active NPI

Chesapeake Family Practice, Inc.

  • Family Nurse Practitioner
  • Salisbury, MD
National Provider Identifier
1124488408
Registry record updated Jul 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R181859 Issued in MD
Legal business name
CHESAPEAKE FAMILY PRACTICE, INC.
Practice address
1201 Pemberton Dr Ste 2a
Salisbury, MD 21801-2501
Phone
(443) 978-7170
Fax
(443) 978-7173
NPI assigned
Mar 1, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2021

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

Authorized official

Name
Jessica Leigh Hill, CRNPNPI 1578953287
Title
Ceo/Owner
Phone
(410) 251-6246

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
Health Maintenance Organization 302R00000X R181859 MD
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X R181859 MD Primary

Addresses

Primary practice location

1201 Pemberton Dr Ste 2a
Salisbury, MD 21801-2501

Mailing address

1201 Pemberton Dr Ste 2a
Salisbury, MD 21801-2501
Phone (443) 978-7170

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160406001235 MD Part B Supplier - Clinic/Group Practice 0244538395 Receives reassigned benefits from 3 practitioners
Practice locations: Salisbury, 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
21D2119161Chesapeake Family Practice1201 Pemberton Dr 2a, Salisbury, MD 21801Certificate of waiverSep 20, 2026

National Provider Directory

National Provider Directory

Locations

1201 Pemberton Dr
Ste 2A
Salisbury, MD 21801
Phone (410) 548-3700

1201 Pemberton Dr
Ste 1B
Salisbury, MD 21801
Phone (302) 236-3643

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": "1456790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627257600000",
    "number": "1124488408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 PEMBERTON DR STE 2A",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218012501",
            "telephone_number": "443-978-7170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 PEMBERTON DR STE 2A",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218012501",
            "telephone_number": "443-978-7170",
            "fax_number": "443-978-7173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESAPEAKE FAMILY PRACTICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-01",
        "last_updated": "2021-07-26",
        "certification_date": "2021-07-26",
        "status": "A",
        "authorized_official_last_name": "HILL",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "LEIGH",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "410-251-6246",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "MD",
            "license": "R181859",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R181859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.