Middlebrook Pediatrics LLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

D0065257 Issued in MD

Legal business name

MIDDLEBROOK PEDIATRICS LLC

Practice address

18528 Office Park Dr
Montgomery Village, MD 20886-0586

Phone

(301) 330-4130

Fax

(301) 330-4150

NPI assigned

Apr 7, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Veronica Omenka, M.D.NPI 1568457687

Title

Physician

Phone

(301) 330-4130

Specialties & licenses 1

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Veronica Chinyelu Omenka, MD

  • Pediatrics Physician
  • Montgomery Village, MD
  • NPI 1568457687
  NPD (past) Authorized official

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

{
    "created_epoch": "1459987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459987200000",
    "number": "1285098137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18528 OFFICE PARK DR",
            "city": "MONTGOMERY VILLAGE",
            "state": "MD",
            "postal_code": "208860586",
            "telephone_number": "301-330-4130",
            "fax_number": "301-330-4150"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18528 OFFICE PARK DR",
            "city": "MONTGOMERY VILLAGE",
            "state": "MD",
            "postal_code": "208860586",
            "telephone_number": "301-330-4130",
            "fax_number": "301-330-4150"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLEBROOK PEDIATRICS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-07",
        "last_updated": "2016-04-07",
        "status": "A",
        "authorized_official_last_name": "OMENKA",
        "authorized_official_first_name": "VERONICA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "301-330-4130",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MD",
            "license": "D0065257",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Montgomery County Maryland Government
• Montgomery County Maryland Government

• Primary Care Clinic/Center in Montgomery Village, MD
• Providers in Montgomery Village, MD by specialty
• Primary Care Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.