NPIMap

Organization Active NPI

Annapolis Pediatrics

  • Non-Pharmacy Dispensing Site
  • Annapolis, MD
National Provider Identifier
1285717512
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
License
D0008186 Issued in MD
Legal business name
ANNAPOLIS PEDIATRICS
Doing business as
Annapolis Pediatrics
Practice address
200 Forbes St
Annapolis, MD 21401-1538
Phone
(410) 263-6363
Fax
(410) 263-7551
NPI assigned
Oct 23, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Direndia Shackelford
Title
Managed Care Specialist
Phone
(800) 654-0889

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X D0008186 MD Primary

Addresses

Primary practice location

200 Forbes St
Annapolis, MD 21401-1538

Mailing address

200 Forbes St
Annapolis, MD 21401-1538

Other identifiers 1

IdentifierTypeStateIssuer
2124713OtherOTHER ID NUMBER-COMMERCIAL NUMBER

Other names 1

  • ANNAPOLIS PEDIATRICS Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Annapolis Pediatrics2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

200 Forbes St
Annapolis, MD 21401
Phone (410) 216-6164

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285717512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 FORBES ST",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214011538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 FORBES ST",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214011538",
            "telephone_number": "410-263-6363",
            "fax_number": "410-263-7551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANNAPOLIS PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHACKELFORD",
        "authorized_official_first_name": "DIRENDIA",
        "authorized_official_title_or_position": "MANAGED CARE SPECIALIST",
        "authorized_official_telephone_number": "800-654-0889"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": "MD",
            "license": "D0008186",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2124713",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ANNAPOLIS PEDIATRICS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 22, 2020; 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.