NPIMap

Organization Active NPI

Choptank Community Health System, Inc.

Doing business as North Caroline High School SBHC

  • Federally Qualified Health Center (FQHC)
  • Ridgely, MD
National Provider Identifier
1508097684
Registry record updated Oct 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CHOPTANK COMMUNITY HEALTH SYSTEM, INC.
Doing business as
North Caroline High School SBHC
Practice address
10990 River Rd
Ridgely, MD 21660-1815
Phone
(410) 479-4653
Fax
(833) 914-0406
NPI assigned
Aug 6, 2009
Last updated
Oct 30, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
CHOPTANK COMMUNITY HEALTH SYSTEM, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 30, 2020

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

Authorized official

Name
Sara Rich
Title
Ceo
Phone
(410) 479-4306

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

10990 River Rd
Ridgely, MD 21660-1815

Mailing address

10990 River Rd
Ridgely, MD 21660-1815
Phone (410) 479-4653

Other identifiers 1

IdentifierTypeStateIssuer
784381008MedicaidMD

Other names 1

  • North Caroline High School SBHC Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Choptank Community Heal103 organizations share this tax ID, including this one
Part of
Choptank Community Heal

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1249516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604016000000",
    "number": "1508097684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10990 RIVER RD",
            "city": "RIDGELY",
            "state": "MD",
            "postal_code": "216601815",
            "telephone_number": "410-479-4653",
            "fax_number": "833-914-0406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10990 RIVER RD",
            "city": "RIDGELY",
            "state": "MD",
            "postal_code": "216601815",
            "telephone_number": "410-479-4653",
            "fax_number": "833-914-0406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHOPTANK COMMUNITY HEALTH SYSTEM, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CHOPTANK COMMUNITY HEALTH SYSTEM, INC.",
        "enumeration_date": "2009-08-06",
        "last_updated": "2020-10-30",
        "certification_date": "2020-10-30",
        "status": "A",
        "authorized_official_last_name": "RICH",
        "authorized_official_first_name": "SARA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "410-479-4306"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "784381008",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Caroline High School SBHC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "North Caroline High School SBHC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ridgely, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2020; 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.