NPIMap

Organization Active NPI

Pediatric Associates

  • Primary Care Clinic/Center
  • Wheaton, MD
National Provider Identifier
1295921534
Registry record updated Sep 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
PEDIATRIC ASSOCIATES
Practice address
2401 Blueridge Ave
Suite 210
Wheaton, MD 20902-4517
Phone
(301) 933-6440
Fax
(301) 933-5923
NPI assigned
Sep 20, 2007
Last updated
Sep 20, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2007

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

Authorized official

Name
Dr. Yorck Gunter Von Conrad, M.D.
Title
President
Phone
(301) 933-6440

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU Primary

Addresses

Primary practice location

2401 Blueridge Ave
Suite 210
Wheaton, MD 20902-4517

Mailing address

2401 Blueridge Ave
Suite 210
Wheaton, MD 20902-4517
Phone (301) 933-6440

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D0213407Pediatric Associates Mont Co2401 Blueridge Avenue Ste 210, Wheaton, MD 20902ComplianceSep 8, 2027

National Provider Directory

National Provider Directory

Locations

2401 Blueridge Ave
Ste 210
Wheaton, MD 20902
Phone (301) 933-6440

Practitioners & affiliated clinicians

Practitioners 18

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 18

NPI Registry JSON

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

{
    "created_epoch": "1190246400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190246400000",
    "number": "1295921534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 BLUERIDGE AVE",
            "address_2": "SUITE 210",
            "city": "WHEATON",
            "state": "MD",
            "postal_code": "209024517",
            "telephone_number": "301-933-6440",
            "fax_number": "301-933-5923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 BLUERIDGE AVE",
            "address_2": "SUITE 210",
            "city": "WHEATON",
            "state": "MD",
            "postal_code": "209024517",
            "telephone_number": "301-933-6440",
            "fax_number": "301-933-5923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-20",
        "last_updated": "2007-09-20",
        "status": "A",
        "authorized_official_last_name": "VON CONRAD",
        "authorized_official_first_name": "YORCK",
        "authorized_official_middle_name": "GUNTER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-933-6440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2007; 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.