Active NPI
Frederick Pediatric Associates P.a.
- Pediatrics Physician
- Frederick, MD
National Provider Identifier
1447075353
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- 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 ASSOCIATES
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 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 NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 21D2068703 | Frederick Pediatric Associates, P a | Certificate of waiver | Nov 11, 2027 |
National Provider Directory
National Provider Directory- Tax ID family
- Nathan and Sobhani PA
- 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.
-
- Pediatrics Physician
- Mount Airy, MD
- NPI 1528883436
-
- Pediatrics Physician
- Frederick, MD
- NPI 1538146717
-
- Pediatrics Physician
- Frederick, MD
- NPI 1891510707
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
- Frederick Oncology Hematology Associates, P.C.
- Frederick Operating, LLC
- Frederick Optometry, LLC
- Frederick Orthodontics Associates LLC
- Frederick Pathology Consultants, PA
- Frederick Pediatric Associates P.a.
- Frederick Pediatric Associates P.a.
- Frederick Pediatric Dentistry, LLC
- Frederick Periodontal Associates
- Frederick Physical Therapy Inc.
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.