NPIMap

Organization Active NPI

Kennedy Krieger Children's Hospital, Inc.

Doing business as Kennedy Krieger Institute - Equipment

  • Customized Equipment (DME)
  • Baltimore, MD
National Provider Identifier
1164638391
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Customized Equipment (DME)Taxonomy code 332BC3200X
License
30-036 Issued in MD
Legal business name
KENNEDY KRIEGER CHILDREN'S HOSPITAL, INC.
Doing business as
Kennedy Krieger Institute - Equipment
Practice address
707 N. Broadway
Baltimore, MD 21205
Phone
(443) 923-9200
Fax
(443) 923-9405
NPI assigned
May 15, 2007
Last updated
Sep 16, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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

Authorized official

Name
Mr. Mike J Neuman
Title
Vice President Finance
Phone
(443) 923-1810

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Customized Equipment (DME) 332BC3200X 30-036 MD Primary

Addresses

Primary practice location

707 N. Broadway
Baltimore, MD 21205

Mailing address

P.O. Box 744865
Atlanta, GA 30374
Phone (443) 923-1886

Other identifiers 1

IdentifierTypeStateIssuer
091678100MedicaidMD

Other names 1

  • Kennedy Krieger Institute - Equipment Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kennedy Krieger Childrens Hospital Inc19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600214400000",
    "number": "1164638391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 744865",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30374",
            "telephone_number": "443-923-1886",
            "fax_number": "443-923-1875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 N. BROADWAY",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21205",
            "telephone_number": "443-923-9200",
            "fax_number": "443-923-9405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNEDY KRIEGER CHILDREN'S HOSPITAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A",
        "authorized_official_last_name": "NEUMAN",
        "authorized_official_first_name": "MIKE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VICE PRESIDENT FINANCE",
        "authorized_official_telephone_number": "443-923-1810",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "MD",
            "license": "30-036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "091678100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kennedy Krieger Institute - Equipment",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.