Paulette D. Anderson, M.D.
Individual provider Active NPI Psychiatry Physician · Chestertown, MD
NPI 1205020161 · NPPES record last updated Sep 4, 2007
Key facts
- NPI
- 1205020161
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- D0047756 (MD)
- Practice address
- 300 Scheeler Rd
Upper Shore Community Mental Health Center
Chestertown, MD 21620-1014 - Phone
- (410) 778-6800
- Fax
- (410) 778-1648
- NPI assigned
- Sep 4, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051202000465 | MD | Practitioner - Psychiatry | 2466472675 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0047756 | MD | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kent County Health Department | Current |
Accepting new patients | |
| Upper Shore Community Mental Health Ctr | Past | Accepting new patients | |
| State of Maryland Central Payroll Bureau | Past | Accepting new patients |
Locations
300 Scheeler Rd
Chestertown, MD 21620
Phone (410) 778-5783
300 Scheeler Rd
Uppr Shr
Chestertown, MD 21620
Phone (410) 778-6800
125 S Lynchburg St
Chestertown, MD 21620
Phone (410) 778-1350
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | D0047756 | MD | Yes |
Addresses
Primary practice location
300 Scheeler Rd
Upper Shore Community Mental Health Center
Chestertown, MD 21620-1014
Mailing address
101 Morgnec Rd
Apartment 201K
Chestertown, MD 21620-1030
Phone (410) 810-1562
Other providers in Chestertown, MD
- Advanced Pain Management Specialists LLC
- Advanced Pain Management Specialists, LLC
- Joyceline Asongalem Acha Alemgang
- Mathew J An
- Kristen Leigh Anderson
- Anthony J Moorman MD and Associates PC
- Emily R Anthony
- Joseph B Aquilla
- Freddy Orlando Araujo-Vidal
- John C. Arrabal
All providers in Chestertown, MD · Psychiatry Physician in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 4, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.