NPIMap

Organization Active NPI

Calvert County Health Department

  • Community Health Clinic/Center
  • Prince Frederick, MD
National Provider Identifier
1740848423
Registry record updated May 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Clinic/CenterTaxonomy code 261QC1500X
Legal business name
CALVERT COUNTY HEALTH DEPARTMENT
Practice address
975 Solomons Island Rd N
Prince Frederick, MD 20678-3917
Phone
(410) 535-5400
Fax
(410) 535-1955
NPI assigned
May 29, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2019

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

Authorized official

Name
Laurence Polsky, MD
Title
Health Officer
Phone
(410) 535-5400

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Health EducatorGroup: 193400000X SINGLE SPECIALTY GROUP 174H00000X
Community Health Clinic/Center 261QC1500X Primary

Addresses

Primary practice location

975 Solomons Island Rd N
Prince Frederick, MD 20678-3917

Mailing address

PO Box 980
Prince Frederick, MD 20678-0980
Phone (410) 535-5400

Other names 1

  • Diabetes Prevention Program Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190926000465 MD MDPP Supplier - in-Person MDPP Supplier 7214188366 Practice locations: Huntingtown, MD; Chesapeake Beach, MD; Solomons, MD; Prince Frederick, MD; Owings, MD; North Beach, MD; Lusby, MD

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
Calvert Cty HLTH Dept21 organizations share this tax ID, including this one

Other organizations with this tax ID 20

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

View all 20

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1559088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559088000000",
    "number": "1740848423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 980",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206780980",
            "telephone_number": "410-535-5400",
            "fax_number": "410-535-1955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 SOLOMONS ISLAND RD N",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206783917",
            "telephone_number": "410-535-5400",
            "fax_number": "410-535-1955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALVERT COUNTY HEALTH DEPARTMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-29",
        "last_updated": "2019-05-29",
        "status": "A",
        "authorized_official_last_name": "POLSKY",
        "authorized_official_first_name": "LAURENCE",
        "authorized_official_title_or_position": "HEALTH OFFICER",
        "authorized_official_telephone_number": "410-535-5400",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diabetes Prevention Program",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Prince Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2019; 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.