NPIMap

Organization Active NPI

P. Michael Patterson

  • Nurse Practitioner
  • La Plata, MD
National Provider Identifier
1649419102
Registry record updated Jan 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R148876 Issued in MD
Legal business name
P. MICHAEL PATTERSON
Practice address
115 La Grange Ave
Suite 101
La Plata, MD 20646-9592
Phone
(301) 392-1935
Fax
(301) 392-1936
NPI assigned
Feb 6, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2025

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

Authorized official

Name
Dr. Paul Michael Patterson, DNP/FNPNPI 1285639617
Title
President
Phone
(301) 392-1935

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
Primary Care Clinic/Center 261QP2300X
Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363L00000X R148876 MD Primary

Addresses

Primary practice location

115 La Grange Ave
Suite 101
La Plata, MD 20646-9592

Mailing address

115-A la Grange Ave
Suite 101
La Plata, MD 20646-9592
Phone (301) 392-1935

Other names 1

  • La Plata Primary Care Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090722000722 MD Part B Supplier - Clinic/Group Practice 4789736786 Receives reassigned benefits from 3 practitioners
Practice locations: La Plata, MD

National Provider Directory

National Provider Directory
Tax ID family
La Plata Primary Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

115 La Grange Ave
Ste 101A
La Plata, MD 20646
Phone (301) 392-1935

115 La Grange Ave
Ste 101
La Plata, MD 20646
Phone (301) 392-1935

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": "1233878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736294400000",
    "number": "1649419102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115-A LA GRANGE AVE",
            "address_2": "SUITE 101",
            "city": "LA PLATA",
            "state": "MD",
            "postal_code": "206469592",
            "telephone_number": "301-392-1935",
            "fax_number": "301-392-1936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 LA GRANGE AVE",
            "address_2": "SUITE 101",
            "city": "LA PLATA",
            "state": "MD",
            "postal_code": "206469592",
            "telephone_number": "301-392-1935",
            "fax_number": "301-392-1936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "P. MICHAEL PATTERSON",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-06",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A",
        "authorized_official_last_name": "PATTERSON",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-392-1935",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP/FNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner",
            "state": "MD",
            "license": "R148876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "La Plata Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in La Plata, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; 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.