Active NPI
Bethany Pediatrics LLC
- Pediatrics Physician
- Ellicott City, MD
National Provider Identifier
1205759180
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- Legal business name
- BETHANY PEDIATRICS LLC
- Practice address
- 10300A Baltimore National Pike
Ellicott City, MD 21042-2128 - Phone
- (410) 465-7337
- Fax
- (410) 465-1620
- NPI assigned
- Jul 30, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Amaka J Undie, MD
- Title
- Physician
- Phone
- (410) 465-7337
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | Primary |
Addresses
Primary practice location
10300A Baltimore National Pike
Ellicott City, MD 21042-2128
Mailing address
10300A Baltimore National Pike
Ellicott City, MD 21042-2128
Phone (410) 465-7337
National Provider Directory
National Provider DirectoryLocations
10300A Baltimore National Pike
Ellicott City, MD 21042
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1785369600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1785369600000",
"number": "1205759180",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10300A BALTIMORE NATIONAL PIKE",
"city": "ELLICOTT CITY",
"state": "MD",
"postal_code": "210422128",
"telephone_number": "410-465-7337",
"fax_number": "410-465-1620"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10300A BALTIMORE NATIONAL PIKE",
"city": "ELLICOTT CITY",
"state": "MD",
"postal_code": "210422128",
"telephone_number": "410-465-7337",
"fax_number": "410-465-1620"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BETHANY PEDIATRICS LLC",
"organizational_subpart": "NO",
"enumeration_date": "2026-07-30",
"last_updated": "2026-07-30",
"certification_date": "2026-07-30",
"status": "A",
"authorized_official_last_name": "UNDIE",
"authorized_official_first_name": "AMAKA",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "PHYSICIAN",
"authorized_official_telephone_number": "410-465-7337",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Pediatrics",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ellicott City, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.