Individual provider Active NPI

Gabriel O. Obiadi, M.D.

  • Pediatrics Physician
  • Laurel, MD
National Provider Identifier
1649267352
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
D0046424 Issued in MD
Practice address
601 7TH St Ste 204
Laurel, MD 20707-4011
Phone
(301) 776-6121
Fax
(301) 776-3860
NPI assigned
Sep 29, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X D0046424 MD Primary

Addresses

Primary practice location

601 7TH St Ste 204
Laurel, MD 20707-4011

Mailing address

601 7TH St Ste 204
Laurel, MD 20707-4011
Phone (301) 776-6121

Other practice location 1

701 Charles St
LA Plata, MD 20646-5930
Phone (301) 609-4000

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
D0046424MDMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Park Place Primary Care LLC Pediatrics Current Accepting new patients
Dimensions Health Corporation Past Accepting new patients
Baltimore Washington Emergency Physicians, Inc. Past Accepting new patients
Harbor Hospital Past Accepting new patients

Locations

601 7th St
Ste 204
Laurel, MD 20707
Phone (301) 776-6121

Organizations & group practices 4

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": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1649267352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 7TH ST STE 204",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207074011",
            "telephone_number": "301-776-6121",
            "fax_number": "301-776-3860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 7TH ST STE 204",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207074011",
            "telephone_number": "301-776-6121",
            "fax_number": "301-776-3860"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "701 Charles St",
            "address_purpose": "LOCATION",
            "city": "LA Plata",
            "state": "MD",
            "postal_code": "206465930",
            "country_code": "US",
            "telephone_number": "301-609-4000",
            "fax_number": "301-609-4410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OBIADI",
        "first_name": "GABRIEL",
        "middle_name": "O.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-29",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MD",
            "license": "D0046424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.