Organization Active NPI

Frederick Pediatric Associates P.a.

  • Pediatrics Physician
  • Frederick, MD
National Provider Identifier
1447075353
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
FREDERICK PEDIATRIC ASSOCIATES P.A.
Practice address
3500 Campus Dr Ste 101
Frederick, MD 21704-7923
Phone
(301) 874-6107
Fax
(301) 874-2496
NPI assigned
Nov 18, 2024
Organization subpart
Yes
Parent organization
FREDERICK PEDIATRIC ASSOCIATESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Authorized official

Name
Mary Jarvis
Title
Office Manager
Phone
(301) 694-0606

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

3500 Campus Dr Ste 101
Frederick, MD 21704-7923

Mailing address

87 Thomas Johnson Dr Ste 101
Frederick, MD 21702-4427
Phone (301) 694-0606

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
21D2068703Frederick Pediatric Associates, P a3500 Campus Drive Ste 102, Urbana, MD 21704Certificate of waiverNov 11, 2027

National Provider Directory

National Provider Directory
Tax ID family
Nathan and Sobhani PA4 organizations share this tax ID, including this one
Part of
Nathan and Sobhani PA

Other organizations with this tax ID 3

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

Locations

3500 Campus Dr
Ste 101
Frederick, MD 21704
Phone (301) 473-5945

87 Thomas Johnson Dr
Ste 101
Frederick, MD 21702
Phone (301) 694-0606

NPI Registry JSON

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

{
    "created_epoch": "1731888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731888000000",
    "number": "1447075353",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "87 THOMAS JOHNSON DR STE 101",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024427",
            "telephone_number": "301-694-0606",
            "fax_number": "877-276-4919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 CAMPUS DR STE 101",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217047923",
            "telephone_number": "301-874-6107",
            "fax_number": "301-874-2496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREDERICK PEDIATRIC ASSOCIATES P.A.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FREDERICK PEDIATRIC ASSOCIATES",
        "enumeration_date": "2024-11-18",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-15",
        "status": "A",
        "authorized_official_last_name": "JARVIS",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "301-694-0606"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 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.