Organization Active NPI

Dr. Richard C. Fidanza LLC

  • Chiropractor
  • Edgewater, MD
National Provider Identifier
1609334978
Registry record updated Mar 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
DR. RICHARD C. FIDANZA LLC
Practice address
2770 Solomons Island Rd
Edgewater, MD 21037-1211
Phone
(410) 266-9000
Fax
(410) 266-9058
NPI assigned
Mar 6, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2026

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

Authorized official

Name
Dr. Richard C Fidanza, DCNPI 1992857015
Title
Doctor/ Sole Owner LLC
Phone
(410) 266-9000

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

2770 Solomons Island Rd
Edgewater, MD 21037-1211

Mailing address

2770 Solomons Island Rd
Edgewater, MD 21037-1211
Phone (410) 266-9000

Other identifiers 3

IdentifierTypeStateIssuer
T77210OtherUPIN
23910070MedicaidMD
DW81-0000OtherCAREFIRST

Other names 1

  • Dr. Richard C. Fidanza DC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190327002242 MD Part B Supplier - Clinic/Group Practice 4688914732 Receives reassigned benefits from 1 practitioner
Practice locations: Edgewater, MD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1551830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1774310400000",
    "number": "1609334978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2770 SOLOMONS ISLAND RD",
            "city": "EDGEWATER",
            "state": "MD",
            "postal_code": "210371211",
            "telephone_number": "410-266-9000",
            "fax_number": "410-266-9058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2770 SOLOMONS ISLAND RD",
            "city": "EDGEWATER",
            "state": "MD",
            "postal_code": "210371211",
            "telephone_number": "410-266-9000",
            "fax_number": "410-266-9058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. RICHARD C. FIDANZA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-06",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A",
        "authorized_official_last_name": "FIDANZA",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DOCTOR/ SOLE OWNER LLC",
        "authorized_official_telephone_number": "410-266-9000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "T77210",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "23910070",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "DW81-0000",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Richard C. Fidanza DC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Edgewater, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2026; 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.