Mithila Jegathesan, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

D0076657 Issued in MD

Practice address

106 Milford St Ste 201
Salisbury, MD 21804-6959

Phone

(410) 543-1616

Fax

(410) 543-8497

NPI assigned

Sep 21, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Chesapeake Pediatric & Adolescent Associates, PA

  • Pediatric Adolescent Medicine Physician
  • Salisbury, MD
  • NPI 1699894857
  NPD (past)

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

{
    "created_epoch": "1221955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1376793810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 MILFORD ST STE 201",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218046959",
            "telephone_number": "410-543-1616",
            "fax_number": "410-543-8497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 MILFORD ST STE 201",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218046959",
            "telephone_number": "410-543-1616",
            "fax_number": "410-543-8497"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29 Broad St Ste 201",
            "address_purpose": "LOCATION",
            "city": "Berlin",
            "state": "MD",
            "postal_code": "218111054",
            "country_code": "US",
            "telephone_number": "410-543-1616",
            "fax_number": "410-543-8497",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JEGATHESAN",
        "first_name": "MITHILA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-21",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0076657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "119591300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa A Jeffers, CRNP, CWS
• Angela Marie Jefferson, CRNP-F
• Emmanuel Jefferson, LCSW-C
• Jeffrey L Taylor DDS and Associates II PC
• Ryan Jeffries, MD
• Tania Jenkins, NP-C
• Treasure Jenkins
• Byron Lee Jennings, MD
• Jerica Counseling, LLC
• Elizabeth Mitchell Jester, CSC-AD

• Pediatrics Physician in Salisbury, MD
• Providers in Salisbury, MD by specialty
• Pediatrics Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.