NPIMap

Organization Active NPI

Chesapeake Orthopaedic and Sports Medicine Center PA

  • Orthopaedic Surgery Physician
  • Glen Burnie, MD
National Provider Identifier
1407920143
Registry record updated Aug 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
Legal business name
CHESAPEAKE ORTHOPAEDIC AND SPORTS MEDICINE CENTER PA
Practice address
200 Hospital Drive
Glen Burnie, MD 21061
Phone
(410) 768-5555
Fax
(410) 768-5835
NPI assigned
Nov 17, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2010

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

Authorized official

Name
Ms. Beverly J Gazmen, CMPE
Title
Chief Executive Officer
Phone
(410) 768-5555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X Primary

Addresses

Primary practice location

200 Hospital Drive
Glen Burnie, MD 21061

Mailing address

200 Hospital Drive
Glen Burnie, MD 21061
Phone (410) 768-5555

Other identifiers 1

IdentifierTypeStateIssuer
912851400MedicaidMD

Other names 1

  • Drs Courtney, Keats & Jaworski PA Former legal business name

National Provider Directory

National Provider Directory

Locations

200 Hospital Dr
Ste 206
Glen Burnie, MD 21061
Phone (301) 768-5555

200 Hospital Dr
Fl Second
Glen Burnie, MD 21061

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 21

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.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281916800000",
    "number": "1407920143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HOSPITAL DRIVE",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "21061",
            "telephone_number": "410-768-5555",
            "fax_number": "410-768-5835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HOSPITAL DRIVE",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "21061",
            "telephone_number": "410-768-5555",
            "fax_number": "410-768-5835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESAPEAKE ORTHOPAEDIC AND SPORTS MEDICINE CENTER PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2010-08-16",
        "status": "A",
        "authorized_official_last_name": "GAZMEN",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "410-768-5555",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "CMPE"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "912851400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Drs Courtney, Keats & Jaworski PA",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Glen Burnie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2010; 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.