NPIMap

Individual provider Active NPI

Elizabeth F Shade, MD

  • Internal Medicine Physician
  • Annapolis, MD
National Provider Identifier
1487631057
Registry record updated Oct 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
D0044305 Issued in MD
Practice address
2001 Medical Pkwy
Annapolis, MD 21401-3280
Phone
(443) 481-1000
Fax
(410) 280-6515
NPI assigned
Dec 27, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X D0044305 MD Primary

Addresses

Primary practice location

2001 Medical Pkwy
Annapolis, MD 21401-3280

Mailing address

PO Box 64916
Baltimore, MD 21264-4916
Phone (443) 481-6573

Other identifiers 4

IdentifierTypeStateIssuer
0003OtherDCCAREFIRST BCBS
53083103OtherMDCAREFIRST BCBS
5886085OtherMDAETNA PPO
3377019OtherMDAETNA HMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0044305MDMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anne Arundel Medical Center Inc Past Accepting new patients
Anne Arundel Medical Center Inc Past Accepting new patients
Anne Arundel Medical Center Inc Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1135641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192665600000",
    "number": "1487631057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 64916",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212644916",
            "telephone_number": "443-481-6573",
            "fax_number": "443-481-6515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 MEDICAL PKWY",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013280",
            "telephone_number": "443-481-1000",
            "fax_number": "410-280-6515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHADE",
        "first_name": "ELIZABETH",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-27",
        "last_updated": "2007-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0044305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "0003",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "53083103",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "5886085",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "3377019",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2007; 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.