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
1376715383
Registry record updated Sep 16, 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
2040 E. 32ND St.
Montebello School
Baltimore, MD 21218
Phone
(410) 235-4801
Fax
(443) 923-9405
NPI assigned
Mar 31, 2008
Last updated
Sep 16, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 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
Developmental Disabilities Clinic/Center 261QD1600X 30-036 MD Primary
School Social Worker 1041S0200X MD
Case Management Registered Nurse 163WC0400X MD
Physical Therapist 225100000X MD
Occupational Therapist 225X00000X MD
Speech-Language Pathologist 235Z00000X MD

Addresses

Primary practice location

2040 E. 32ND St.
Montebello School
Baltimore, MD 21218

Mailing address

PO Box 744865
Patient Accounting Helena Porter
Atlanta, GA 30374
Phone (443) 923-1886

Other identifiers 1

IdentifierTypeStateIssuer
1754815 04MedicaidMD

Other names 1

  • Kennedy Krieger School Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Kennedy Krieger Education and Communication12 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

2040 E 32nd St
Baltimore, MD 21218
Phone (410) 235-4801

NPI Registry JSON

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

{
    "created_epoch": "1206921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600214400000",
    "number": "1376715383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 744865",
            "address_2": "PATIENT ACCOUNTING HELENA PORTER",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "30374",
            "telephone_number": "443-923-1886",
            "fax_number": "443-923-1895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 E. 32ND ST.",
            "address_2": "MONTEBELLO SCHOOL",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21218",
            "telephone_number": "410-235-4801",
            "fax_number": "443-923-9405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNEDY KRIEGER EDUCATION AND COMMUNITY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-31",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "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": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": "MD",
            "license": "30-036",
            "primary": true
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1754815 04",
            "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 16, 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.