NPIMap

Organization Active NPI

Healthport

  • Primary Care Clinic/Center
  • Princess Anne, MD
National Provider Identifier
1487452934
Registry record updated Mar 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
HEALTHPORT
Practice address
11559 Somerset Ave
Princess Anne, MD 21853-1067
Phone
(410) 341-3420
Fax
(410) 341-3397
NPI assigned
Mar 3, 2025
Last updated
Mar 3, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2025

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

Authorized official

Name
Kristine R GarlitzNPI 1356608137
Title
Vice President
Phone
(410) 202-2651

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X NU Primary

Addresses

Primary practice location

11559 Somerset Ave
Princess Anne, MD 21853-1067

Mailing address

208 E Main St Ste B
Salisbury, MD 21801-4923
Phone (410) 341-3420

Other names 1

  • Lower Shore Clinic, Inc Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051102000426 MD Part B Supplier - Clinic/Group Practice 2365469947 Receives reassigned benefits from 15 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Newark, MD; Salisbury, MD; Princess Anne, MD; Cambridge, MD

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Lower Shore Clinic Inc15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Locations

208 E Main St
Ste B
Salisbury, MD 21801

Practitioners & affiliated clinicians

Practitioners 18

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 18

NPI Registry JSON

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

{
    "created_epoch": "1740960000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740960000000",
    "number": "1487452934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 E MAIN ST STE B",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218014923",
            "telephone_number": "410-341-3420",
            "fax_number": "410-341-3397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11559 SOMERSET AVE",
            "city": "PRINCESS ANNE",
            "state": "MD",
            "postal_code": "218531067",
            "telephone_number": "410-341-3420",
            "fax_number": "410-341-3397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHPORT",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-03",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A",
        "authorized_official_last_name": "GARLITZ",
        "authorized_official_first_name": "KRISTINE",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "410-202-2651"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lower Shore Clinic, Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Princess Anne, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.