NPIMap

Organization Active NPI

Eastern Shore Brokers, LLC

  • Case Management Agency
  • Whaleyville, MD
National Provider Identifier
1669988515
Registry record updated Dec 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
EASTERN SHORE BROKERS, LLC
Practice address
12641 Blueberry Rd
Whaleyville, MD 21872-2013
Phone
(410) 726-2967
NPI assigned
Dec 14, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2017

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

Authorized official

Name
Cynthia TruittNPI 1225546526
Title
Owner/Case Management
Phone
(443) 614-8873

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
Case Management Agency 251B00000X Primary
Developmentally Disabled Services Day Training Agency 251C00000X

Addresses

Primary practice location

12641 Blueberry Rd
Whaleyville, MD 21872-2013

Mailing address

PO Box 123
Whaleyville, MD 21872-0123

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1513209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513209600000",
    "number": "1669988515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 123",
            "city": "WHALEYVILLE",
            "state": "MD",
            "postal_code": "218720123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12641 BLUEBERRY RD",
            "city": "WHALEYVILLE",
            "state": "MD",
            "postal_code": "218722013",
            "telephone_number": "410-726-2967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN SHORE BROKERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-14",
        "last_updated": "2017-12-14",
        "status": "A",
        "authorized_official_last_name": "TRUITT",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "OWNER/CASE MANAGEMENT",
        "authorized_official_telephone_number": "443-614-8873"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whaleyville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2017; 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.