NPIMap

Organization Active NPI

Anne Arundel Dermatology, PA

  • Dermatology Physician
  • Annapolis, MD
National Provider Identifier
1285468231
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
ANNE ARUNDEL DERMATOLOGY, PA
Practice address
180 Admiral Cochrane Dr Ste 410
Annapolis, MD 21401-8405
Phone
(410) 263-5439
NPI assigned
Aug 30, 2024
Last updated
Sep 17, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
ANNE ARUNDEL DERMATOLOGY, PAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Authorized official

Name
Angela Ruth Peterman
Title
MD
Phone
(443) 351-3376

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X NU
Dermatology Physician 207N00000X NU Primary

Addresses

Primary practice location

180 Admiral Cochrane Dr Ste 410
Annapolis, MD 21401-8405

Mailing address

1306 Concourse Dr Ste 201
Linthicum Heights, MD 21090-1033

Other names 1

  • Anne Arundel Dermatology, PA Other name

National Provider Directory

National Provider Directory
Tax ID family
Anne Arundel Dermatology PA36 organizations share this tax ID, including this one
Part of
Anne Arundel Dermatology PA

Other organizations with this tax ID 35

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

View all 35

Locations

180 Admiral Cochrane Dr
Ste 410
Annapolis, MD 21401
Phone (410) 263-5439

180 Admiral Cochrane Dr
Ste 410420
Annapolis, MD 21401

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1724976000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726531200000",
    "number": "1285468231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1306 CONCOURSE DR STE 201",
            "city": "LINTHICUM HEIGHTS",
            "state": "MD",
            "postal_code": "210901033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 ADMIRAL COCHRANE DR STE 410",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214018405",
            "telephone_number": "410-263-5439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANNE ARUNDEL DERMATOLOGY, PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ANNE ARUNDEL DERMATOLOGY, PA",
        "enumeration_date": "2024-08-30",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A",
        "authorized_official_last_name": "PETERMAN",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "RUTH",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "443-351-3376"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Anne Arundel Dermatology, PA",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Anne Arundel Dermatology, PA",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 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.