Organization Active NPI

Chesapeake Cardiac Care, P.a.

  • Cardiovascular Disease Physician
  • Bowie, MD
National Provider Identifier
1740354182
Registry record updated Jun 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
CHESAPEAKE CARDIAC CARE, P.A.
Practice address
16900 Science Dr Ste 200
Bowie, MD 20715-4425
Phone
(410) 573-9805
Fax
(410) 573-9806
NPI assigned
Nov 18, 2006
Last updated
Jun 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2022

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

Authorized official

Name
Ms. Page Smith
Title
Practice Manager
Phone
(410) 573-9805

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X Primary

Addresses

Primary practice location

16900 Science Dr Ste 200
Bowie, MD 20715-4425

Mailing address

16900 Science Dr Ste 200
Bowie, MD 20715-4425
Phone (410) 573-9805

Other identifiers 1

IdentifierTypeStateIssuer
500202800MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040305000404 DC Part B Supplier - Clinic/Group Practice 4880582527 Receives reassigned benefits from 3 practitioners
Practice locations: Bowie, MD
O20050215000959 MD Part B Supplier - Clinic/Group Practice 4880582527 Receives reassigned benefits from 4 practitioners
Practice locations: Annapolis, MD

National Provider Directory

National Provider Directory

Locations

4000 River Crescent Dr
Annapolis, MD 21401
Phone (410) 224-8108

888 Bestgate Rd
Ste 215
Annapolis, MD 21401
Phone (410) 573-9805

Practitioners & affiliated clinicians

Practitioners 5

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": "1163808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655683200000",
    "number": "1740354182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16900 SCIENCE DR STE 200",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207154425",
            "telephone_number": "410-573-9805",
            "fax_number": "410-573-9806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16900 SCIENCE DR STE 200",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207154425",
            "telephone_number": "410-573-9805",
            "fax_number": "410-573-9806"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESAPEAKE CARDIAC CARE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-18",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "PAGE",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "410-573-9805",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500202800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2022; 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.