Active NPI
Chesapeake Pediatric & Adolescent Associates, PA
- Pediatric Adolescent Medicine Physician
- Salisbury, MD
National Provider Identifier
1699894857
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Adolescent Medicine Physician
- Legal business name
- CHESAPEAKE PEDIATRIC & ADOLESCENT ASSOCIATES, PA
- Practice address
- 106 Milford St Ste 201
Salisbury, MD 21804-6959 - Phone
- (410) 543-1616
- Fax
- (410) 543-8497
- NPI assigned
- Mar 28, 2007
- Last updated
- Sep 16, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kim Watson
- Title
- Operations Coordinator
- Phone
- (410) 543-1616
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Adolescent Medicine Physician | 2080A0000X | MD | Primary |
Addresses
Primary practice location
106 Milford St Ste 201
Salisbury, MD 21804-6959
Mailing address
106 Milford St Ste 201
Salisbury, MD 21804-6959
Phone (410) 543-1616
Other identifiers 11
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 430401200 | Other | MD | MARYLAND PHYSICIANS CARE |
| 430401201 | Medicaid | MD | |
| 826426 | Other | MD | PRIORITY PARTNERS |
| G113 | Other | MD | BLUE CROSS BLUE CHOICE |
| 283952 | Other | MD | COVENTRY HEALTHCARE |
| 430401200 | Medicaid | MD | |
| 4560463 | Other | MD | AETNA |
| G113-0000 | Other | MD | CAREFIRST |
| S758CH | Other | MD | BLUE CROSS BLUE SHIELD |
| 213297 | Other | MD | UNITED HEALTHCARE |
| 188017 | Other | MD | AMERIGROUP COMMUNITY CARE |
National Provider Directory
National Provider Directory- Tax ID family
- Chesapeake Pediatric Adolescent Associates PA
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Pediatrics Physician
- Berlin, MD
- NPI 1073340907
-
- Professional Counselor
- Salisbury, MD
- NPI 1922987858
Locations
106 Milford St
Ste 201
Salisbury, MD 21804
Phone (410) 543-1616
Practitioners & affiliated clinicians
Practitioners 4
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.
-
- Pediatrics Physician
- Salisbury, MD
- NPI 1376793810
-
- Pediatrics Physician
- Salisbury, MD
- NPI 1083700488
-
- Pediatrics Physician
- Salisbury, MD
- NPI 1063508539
-
- Pediatrics Physician
- Salisbury, MD
- NPI 1124109855
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175040000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1726444800000",
"number": "1699894857",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "106 MILFORD ST STE 201",
"city": "SALISBURY",
"state": "MD",
"postal_code": "218046959",
"telephone_number": "410-543-1616",
"fax_number": "410-543-8497"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 MILFORD ST STE 201",
"city": "SALISBURY",
"state": "MD",
"postal_code": "218046959",
"telephone_number": "410-543-1616",
"fax_number": "410-543-8497"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHESAPEAKE PEDIATRIC & ADOLESCENT ASSOCIATES, PA",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-28",
"last_updated": "2024-09-16",
"certification_date": "2024-09-16",
"status": "A",
"authorized_official_last_name": "WATSON",
"authorized_official_first_name": "KIM",
"authorized_official_title_or_position": "OPERATIONS COORDINATOR",
"authorized_official_telephone_number": "410-543-1616"
},
"taxonomies": [
{
"code": "2080A0000X",
"taxonomy_group": "",
"desc": "Pediatrics, Adolescent Medicine",
"state": "MD",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MARYLAND PHYSICIANS CARE",
"identifier": "430401200",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "430401201",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PRIORITY PARTNERS",
"identifier": "826426",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE CHOICE",
"identifier": "G113",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COVENTRY HEALTHCARE",
"identifier": "283952",
"state": "MD"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "430401200",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4560463",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST",
"identifier": "G113-0000",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "S758CH",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "213297",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP COMMUNITY CARE",
"identifier": "188017",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Salisbury, MD
- Chesapeake Eye Center, P.a.
- Chesapeake Family Practice, Inc.
- Chesapeake Hearing Centers, Inc.
- Chesapeake Medical Solutions, PA (Your Docs In)
- Chesapeake Music Therapy LLC
- Chesapeake Pediatric & Adolescent Associates, PA
- Chesapeake Rehab Equipment Inc. (Numotion)
- Chesapeake Surgery Center
- Chesapeake Treatment Services Salisbury
- Chesapeake Treatment Services Salisbury
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 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.