NPIMap

Organization Active NPI

Healthport

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Salisbury, MD
National Provider Identifier
1154320646
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
HEALTHPORT
Practice address
505 E Main St
Salisbury, MD 21804
Phone
(410) 341-3420
Fax
(410) 341-3397
NPI assigned
Jul 18, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

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

Authorized official

Name
Kristine Gartlitz
Title
Vice President
Phone
(410) 202-2651

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X MD Primary

Addresses

Primary practice location

505 E Main St
Salisbury, MD 21804

Mailing address

208 E Main St Ste C
Salisbury, MD 21801-4923
Phone (410) 341-3420

Other identifiers 2

IdentifierTypeStateIssuer
298470900MedicaidMD
LS92OtherMDBLUE CROSS BLUE SHIELD MD

Other names 1

  • Lower Shore Clinic, Inc Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051102000426 MD Part B Supplier - Clinic/Group Practice 2365469947 Receives reassigned benefits from 15 practitioners
7 other NPIs on this enrollment
Practice locations: Newark, MD; Salisbury, MD; Princess Anne, MD; Cambridge, MD

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

11559 Somerset Ave
Princess Anne, MD 21853
Phone (410) 334-6961

106 Williamsport Cir
Salisbury, MD 21804

Practitioners & affiliated clinicians

Practitioners 21

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

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1121644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741046400000",
    "number": "1154320646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 E MAIN ST STE C",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218014923",
            "telephone_number": "410-341-3420",
            "fax_number": "410-341-3397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 E MAIN ST",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "21804",
            "telephone_number": "410-341-3420",
            "fax_number": "410-341-3397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHPORT",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-18",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A",
        "authorized_official_last_name": "GARTLITZ",
        "authorized_official_first_name": "KRISTINE",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "410-202-2651"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "298470900",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MD",
            "identifier": "LS92",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lower Shore Clinic, Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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 Mar 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.