NPIMap

Organization Active NPI

Pediatrix of Maryland PA

  • Neonatal-Perinatal Medicine Physician
  • Cumberland, MD
National Provider Identifier
1265289359
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neonatal-Perinatal Medicine PhysicianTaxonomy code 2080N0001X
Legal business name
PEDIATRIX OF MARYLAND PA
Practice address
12500 Willowbrook Rd
Cumberland, MD 21502-6393
Phone
(240) 964-7000
NPI assigned
May 6, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Authorized official

Name
Nicholas E. Glaser
Title
Assistant Secretary
Phone
(954) 384-0175

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neonatal-Perinatal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080N0001X Primary

Addresses

Primary practice location

12500 Willowbrook Rd
Cumberland, MD 21502-6393

Mailing address

PO Box 100445
Atlanta, GA 30384-0445

Other identifiers 1

IdentifierTypeStateIssuer
445000107MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
Pediatrix of Maryland PA7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

NPI Registry JSON

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

{
    "created_epoch": "1714953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730678400000",
    "number": "1265289359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100445",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303840445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12500 WILLOWBROOK RD",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215026393",
            "telephone_number": "240-964-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIX OF MARYLAND PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-05-06",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A",
        "authorized_official_last_name": "GLASER",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "954-384-0175"
    },
    "taxonomies": [
        {
            "code": "2080N0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Neonatal-Perinatal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "445000107",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumberland, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2024; 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.