Shoreline Wellness and Primary Care LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SHORELINE WELLNESS AND PRIMARY CARE LLC

Practice address

314 Franklin Ave Ste 301
Berlin, MD 21811-1238

Phone

(410) 513-4046

NPI assigned

Mar 13, 2023

Organization subpart

No

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

Authorized official

Name

Melissa Emmerich

Title

Managing Member

Phone

(667) 288-3063

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

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

CLIA laboratory certificates

Practitioners 3

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

• Leah Kay Calderon, FNP

  • Family Nurse Practitioner
  • Linthicum Heights, MD
  • NPI 1285373175

  Single Specialty

  Medicare reassignment NPD
• Amanda Matarese Prather, PA-C

  • Medical Physician Assistant
  • Salisbury, MD
  • NPI 1891196218
  Medicare reassignment
• Melissa Anne Youtz, CRNP

  • Family Nurse Practitioner
  • Berlin, MD
  • NPI 1275919540
  NPD

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

{
    "created_epoch": "1678665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714435200000",
    "number": "1376244707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 FRANKLIN AVE STE 301",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218111238",
            "telephone_number": "667-288-3063",
            "fax_number": "833-471-3424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 FRANKLIN AVE STE 301",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218111238",
            "telephone_number": "410-513-4046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORELINE WELLNESS AND PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-13",
        "last_updated": "2024-04-30",
        "certification_date": "2024-04-30",
        "status": "A",
        "authorized_official_last_name": "EMMERICH",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "667-288-3063"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tammy Lou Shanks
• Alyssa Sherr
• Ralph Sherwood, PT
• Shore Regional Eye Care, LLC
• Shore Therapy Solutions, LLC
• Shorewellness and Med Spa, LLC
• Gary Short, PT
• Alexa Lynn Yetta Shoultes, LCSW-C
• Roxanne Suzette Shuman, LGSW
• Chandler Littleton Siers

• Family Medicine Physician in Berlin, MD
• Providers in Berlin, MD by specialty
• Family Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.