Organization Active NPI

Meadowridge Pediatrics, LLC

  • Pediatrics Physician
  • Elkridge, MD
National Provider Identifier
1568109189
Registry record updated Sep 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
MEADOWRIDGE PEDIATRICS, LLC
Practice address
6020 Meadowridge Center Dr Ste P1
Elkridge, MD 21075-6528
Phone
(443) 936-8821
NPI assigned
May 16, 2022
Last updated
Sep 12, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2022

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

Authorized official

Name
Mrs. Celine Chang, CPNP-PCNPI 1982299921
Title
Nurse Practitioner/Owner
Phone
(443) 492-9466

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary
Clinic/Center 261Q00000X NU

Addresses

Primary practice location

6020 Meadowridge Center Dr Ste P1
Elkridge, MD 21075-6528

Mailing address

6020 Meadowridge Center Dr Ste P1
Elkridge, MD 21075-6528
Phone (443) 492-9466

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
21D2272874Meadowridge Pediatrics LLC6020 Meadowridge Center Dr #P1, Elkridge, MD 21075Certificate of waiverNov 30, 2026

National Provider Directory

National Provider Directory

Locations

6020 Meadowridge Center Dr
#P1
Elkridge, MD 21075

6020 Meadowridge Center Dr
Ste P1
Elkridge, MD 21075
Phone (443) 492-9466

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1652659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1662940800000",
    "number": "1568109189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6020 MEADOWRIDGE CENTER DR STE P1",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210756528",
            "telephone_number": "443-492-9466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6020 MEADOWRIDGE CENTER DR STE P1",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210756528",
            "telephone_number": "443-936-8821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEADOWRIDGE PEDIATRICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-16",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "CELINE",
        "authorized_official_title_or_position": "NURSE PRACTITIONER/OWNER",
        "authorized_official_telephone_number": "443-492-9466",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CPNP-PC"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkridge, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2022; 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.