NPIMap

Organization Active NPI

Kennedy Krieger Education and Community Services, Inc.

Doing business as Kennedy Krieger School

  • Developmental Disabilities Clinic/Center
  • Baltimore, MD
National Provider Identifier
1366540619
Registry record updated Sep 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
License
30-036 Issued in MD
Legal business name
KENNEDY KRIEGER EDUCATION AND COMMUNITY SERVICES, INC.
Doing business as
Kennedy Krieger School
Practice address
1750 E Fairmont Ave.
Baltimore, MD 21231
Phone
(443) 923-9100
Fax
(443) 923-4525
NPI assigned
Sep 20, 2006
Last updated
Sep 15, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2020

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

Authorized official

Name
Mr. Mike J Neuman
Title
Vice President Finance
Phone
(443) 923-1810

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
School Social Worker 1041S0200X NU
Case Management Registered Nurse 163WC0400X NU
Physical Therapist 225100000X NU
Occupational Therapist 225X00000X NU
Speech-Language Pathologist 235Z00000X NU
Developmental Disabilities Clinic/Center 261QD1600X 30-036 MD Primary

Addresses

Primary practice location

1750 E Fairmont Ave.
Baltimore, MD 21231

Mailing address

PO Box 744865
Atlanta, GA 30374
Phone (443) 923-1886

Other identifiers 2

IdentifierTypeStateIssuer
1754815 00OtherMDKKI SCHOOL FAIRMOUNT
175481500MedicaidMD

Other names 1

  • Kennedy Krieger School Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kennedy Krieger Education and Community Services Inc12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Locations

2931 E Biddle St
Baltimore, MD 21213
Phone (443) 923-1872

Practitioners & affiliated clinicians

Practitioners 1

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": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600128000000",
    "number": "1366540619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 744865",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30374",
            "telephone_number": "443-923-1886",
            "fax_number": "443-923-1875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 E FAIRMONT AVE.",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21231",
            "telephone_number": "443-923-9100",
            "fax_number": "443-923-4525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNEDY KRIEGER EDUCATION AND COMMUNITY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A",
        "authorized_official_last_name": "NEUMAN",
        "authorized_official_first_name": "MIKE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "VICE PRESIDENT FINANCE",
        "authorized_official_telephone_number": "443-923-1810",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "MD",
            "license": "30-036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KKI SCHOOL FAIRMOUNT",
            "identifier": "1754815 00",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "175481500",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Kennedy Krieger School",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kennedy Krieger School",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 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.