NPIMap

Organization Active NPI

Shore Health System Inc

Doing business as Denton Diagnostic Center

  • Radiology Clinic/Center
  • Denton, MD
National Provider Identifier
1659899763
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name
SHORE HEALTH SYSTEM INC
Doing business as
Denton Diagnostic Center
Practice address
1140 Blades Farm Road
Ste 102
Denton, MD 21629-3459
Phone
(410) 479-3510
Fax
(410) 479-3527
NPI assigned
Sep 8, 2017
Last updated
Nov 27, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
SHORE HEALTH SYSTEM INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Authorized official

Name
Kenneth D Kozel
Title
President and Ceo
Phone
(410) 822-1000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X NU Primary

Addresses

Primary practice location

1140 Blades Farm Road
Ste 102
Denton, MD 21629-3459

Mailing address

1140 Blades Farm Rd
Ste 102
Denton, MD 21629-3459
Phone (410) 479-3510

Other names 1

  • Denton Diagnostic Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171214000293 MD Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 8022906783 Practice locations: Denton, MD

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Shore Gynecology20 organizations share this tax ID, including this one
Part of
Shore Gynecology

Other organizations with this tax ID 19

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

View all 19

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

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": "1504828800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701043200000",
    "number": "1659899763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 BLADES FARM RD",
            "address_2": "STE 102",
            "city": "DENTON",
            "state": "MD",
            "postal_code": "216293459",
            "telephone_number": "410-479-3510",
            "fax_number": "410-479-3527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 BLADES FARM ROAD",
            "address_2": "STE 102",
            "city": "DENTON",
            "state": "MD",
            "postal_code": "216293459",
            "telephone_number": "410-479-3510",
            "fax_number": "410-479-3527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORE HEALTH SYSTEM INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SHORE HEALTH SYSTEM INC",
        "enumeration_date": "2017-09-08",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A",
        "authorized_official_last_name": "KOZEL",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "410-822-1000"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Denton Diagnostic Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Denton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; 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.