NPIMap

Organization Active NPI

Robert M. Ricketts, MD, PA

  • Specialist
  • Westminster, MD
National Provider Identifier
1295768851
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
D0039296 Issued in MD
Legal business name
ROBERT M. RICKETTS, MD, PA
Practice address
910 Washington Rd
Suite E
Westminster, MD 21157-5827
Phone
(410) 876-9111
Fax
(410) 857-3345
NPI assigned
Jul 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Dr. Robert Mason Ricketts Jr., M.D.NPI 1699954602
Title
Physician
Phone
(410) 876-9111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X D0039296 MD Primary

Addresses

Primary practice location

910 Washington Rd
Suite E
Westminster, MD 21157-5827

Mailing address

910 Washington Rd
Suite E
Westminster, MD 21157-5827
Phone (410) 876-9111

Other identifiers 4

IdentifierTypeStateIssuer
629050OtherMDMAMSI/UHC PROVIDER#
2534363OtherMDAETNA PROV #
2500754OtherMDUHC PROVIDER#
596AROOtherMDBC & BS MEMBER #

National Provider Directory

National Provider Directory

Locations

910 Washington Rd
Ste E
Westminster, MD 21157
Phone (410) 857-1200

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1295768851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 WASHINGTON RD",
            "address_2": "SUITE E",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211575827",
            "telephone_number": "410-876-9111",
            "fax_number": "410-857-3345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "910 WASHINGTON RD",
            "address_2": "SUITE E",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211575827",
            "telephone_number": "410-876-9111",
            "fax_number": "410-857-3345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT M. RICKETTS, MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-08",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "RICKETTS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "MASON",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "410-876-9111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MD",
            "license": "D0039296",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI/UHC PROVIDER#",
            "identifier": "629050",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROV #",
            "identifier": "2534363",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC PROVIDER#",
            "identifier": "2500754",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC & BS MEMBER #",
            "identifier": "596ARO",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westminster, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.