Individual provider Active NPI

Dawn Kobrin-Merritts, M.D.

  • Pediatrics Physician
  • Baltimore, MD
National Provider Identifier
1184636680
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D0035365 Issued in MD
Practice address
9649 Belair Rd
Second Floor
Baltimore, MD 21236-1100
Phone
(410) 256-9340
NPI assigned
Aug 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X D0035365 MD Primary

Addresses

Primary practice location

9649 Belair Rd
Second Floor
Baltimore, MD 21236-1100

Mailing address

303 Aiken Ter
Abingdon, MD 21009-2003
Phone (410) 515-1628

Other identifiers 13

IdentifierTypeStateIssuer
1974498OtherUNITED HEALTHCARE
1974498MedicaidMD
93107MedicaidMD
0546322005OtherCIGNA
2331051OtherAETNA HMO
039241OtherJOHNS HOPKINS HEALTHCARE
281937OtherMAMSI
35147703OtherCAREFIRST BCBS MARYLAND
9992OtherKAISER
110807OtherCOVENTRY
700303OtherNCPPO
0010OtherMDCAREFIRST DC
5841082OtherAETNA PPO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110110000042 MD Practitioner - Pediatric Medicine 4486843232 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0035365MDMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lifebridge Community Physicians, Inc Current Accepting new patients
Lifebridge Community Physicians, Inc. CurrentSince Sep 5, 2018 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
Potomac Physicians PA Pediatrics Past Accepting new patients

Locations

9649 Belair Rd
Fl Second
Nottingham, MD 21236
Phone (410) 248-2650

9649 Belair Rd
Fl 2
Nottingham, MD 21236
Phone (410) 256-9340

9649 Belair Rd
#2
Nottingham, MD 21236

410 Malcolm Dr
Ste A
Westminster, MD 21157
Phone (410) 876-1633

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1184636680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 AIKEN TER",
            "city": "ABINGDON",
            "state": "MD",
            "postal_code": "210092003",
            "telephone_number": "410-515-1628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9649 BELAIR RD",
            "address_2": "SECOND FLOOR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212361100",
            "telephone_number": "410-256-9340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOBRIN-MERRITTS",
        "first_name": "DAWN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-13",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0035365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1974498",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1974498",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "93107",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "0546322005",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "2331051",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "JOHNS HOPKINS HEALTHCARE",
            "identifier": "039241",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "281937",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS MARYLAND",
            "identifier": "35147703",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KAISER",
            "identifier": "9992",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY",
            "identifier": "110807",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPPO",
            "identifier": "700303",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST DC",
            "identifier": "0010",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "5841082",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.