NPIMap

Organization Active NPI

Upper Chesapeake Primary Care,LLC

  • Internal Medicine Physician
  • Forest Hill, MD
National Provider Identifier
1386490613
Registry record updated Apr 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
UPPER CHESAPEAKE PRIMARY CARE,LLC
Practice address
2 Colgate Dr Ste 103
Forest Hill, MD 21050-2623
Phone
(410) 420-0161
NPI assigned
Apr 26, 2024
Last updated
Apr 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2024

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

Authorized official

Name
Marcus Thomas Augustus Priolo
Title
Cfo
Phone
(443) 643-3344

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

2 Colgate Dr Ste 103
Forest Hill, MD 21050-2623

Mailing address

900 Elkridge Landing Rd FL 2
Linthicum, MD 21090-2924

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
21D1037256Upper Chesapeake Primary Care Forest Hill2 Colgate Drive Ste 103, Forest Hill, MD 21050Certificate of waiverFeb 17, 2027

National Provider Directory

National Provider Directory
Tax ID family
Upper Chesapeake Primary Carellc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

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

NPI Registry JSON

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

{
    "created_epoch": "1714089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714089600000",
    "number": "1386490613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 ELKRIDGE LANDING RD FL 2",
            "city": "LINTHICUM",
            "state": "MD",
            "postal_code": "210902924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 COLGATE DR STE 103",
            "city": "FOREST HILL",
            "state": "MD",
            "postal_code": "210502623",
            "telephone_number": "410-420-0161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UPPER CHESAPEAKE PRIMARY CARE,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-26",
        "last_updated": "2024-04-26",
        "certification_date": "2024-04-26",
        "status": "A",
        "authorized_official_last_name": "PRIOLO",
        "authorized_official_first_name": "MARCUS",
        "authorized_official_middle_name": "THOMAS AUGUSTUS",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "443-643-3344"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hill, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2024; 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.

Verify at the official NPI Registry.