Active NPI
Gold Pediatrics, LLC
- Pediatrics Physician
- Rockville, MD
National Provider Identifier
1316527658
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- Legal business name
- GOLD PEDIATRICS, LLC
- Practice address
- 15005 Shady Grove Rd Ste 450
Rockville, MD 20850-6377 - Phone
- (301) 517-9710
- Fax
- (301) 517-9713
- NPI assigned
- Apr 12, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Errol Keith Douglas, MD
- Title
- Owner
- Phone
- (301) 517-9710
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | Primary |
Addresses
Primary practice location
15005 Shady Grove Rd Ste 450
Rockville, MD 20850-6377
Mailing address
15005 Shady Grove Rd Ste 450
Rockville, MD 20850-6377
Phone (301) 517-9710
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 014465700 | Medicaid | MD |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 21D2237877 | Gold Pediatrics LLC | Certificate of waiver | Sep 28, 2027 |
National Provider Directory
National Provider DirectoryLocations
15005 Shady Grove Rd
Ste 450
Rockville, MD 20850
Phone (301) 517-9710
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/GCCFCD
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618185600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1674518400000",
"number": "1316527658",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15005 SHADY GROVE RD STE 450",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208506377",
"telephone_number": "301-517-9710",
"fax_number": "301-517-9713"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15005 SHADY GROVE RD STE 450",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208506377",
"telephone_number": "301-517-9710",
"fax_number": "301-517-9713"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GOLD PEDIATRICS, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-04-12",
"last_updated": "2023-01-24",
"certification_date": "2023-01-24",
"status": "A",
"authorized_official_last_name": "DOUGLAS",
"authorized_official_first_name": "ERROL",
"authorized_official_middle_name": "KEITH",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "301-517-9710",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Pediatrics",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "014465700",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Rockville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2023; 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.