CHMG Corelife, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

CHMG CORELIFE, LLC

Practice address

1036 Saint Nicholas Dr Unit 101
Waldorf, MD 20603-4758

Phone

(240) 261-7170

NPI assigned

Feb 5, 2021

Organization subpart

Yes

Parent organization

CALVERT HEALTH SYSTEM, INC.As reported in NPPES

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

Authorized official

Name

Carolyn Heithaus

Title

Cfo

Phone

(410) 535-8236

Specialties & licenses 5

Addresses

Other names 1

• CalvertHealth Weight Management, LLC Former legal business name

Locations

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

{
    "created_epoch": "1612483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1705363200000",
    "number": "1629660147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1099 WINTERSON RD STE 300",
            "city": "LINTHICUM HEIGHTS",
            "state": "MD",
            "postal_code": "210902279",
            "telephone_number": "800-905-3261",
            "fax_number": "443-836-5606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1036 SAINT NICHOLAS DR UNIT 101",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206034758",
            "telephone_number": "240-261-7170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHMG CORELIFE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CALVERT HEALTH SYSTEM, INC.",
        "enumeration_date": "2021-02-05",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A",
        "authorized_official_last_name": "HEITHAUS",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "410-535-8236"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CalvertHealth Weight Management, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Children'S Pediatricians & Associates, LLC
• Childrens Pediatricians & Assoc
• Lorenzo Childress III, M.D.
• Chiropractic Care Center Inc.
• CHMG Corelife, LLC
• Miri Choe, DPT
• Haeyoung Choi, PHARM.D.
• John Y Choi, M.D.
• Evelyn May Chou, D.D.S.
• Hadia Riaz Choudhary, O.D.

• Family Medicine Physician in Waldorf, MD
• Providers in Waldorf, MD by specialty
• Family Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2024; 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.