NPIMap

Organization Active NPI

Park Place Primary Care LLC

  • Pediatrics Physician
  • Laurel, MD
National Provider Identifier
1750632477
Registry record updated Sep 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PARK PLACE PRIMARY CARE LLC
Practice address
601 7TH St
Suite 204
Laurel, MD 20707-4003
Phone
(301) 776-6121
Fax
(301) 776-3860
NPI assigned
Sep 20, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2012

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

Authorized official

Name
Dr. Gabriel O ObiadiNPI 1649267352
Title
Director
Phone
(301) 776-6121

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

601 7TH St
Suite 204
Laurel, MD 20707-4003

Mailing address

601 7TH St
Suite 204
Laurel, MD 20707-4003
Phone (301) 776-6121

National Provider Directory

National Provider Directory

Locations

601 7th St
Ste 204
Laurel, MD 20707
Phone (301) 776-6121

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": "1348099200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348358400000",
    "number": "1750632477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 7TH ST",
            "address_2": "SUITE 204",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207074003",
            "telephone_number": "301-776-6121",
            "fax_number": "301-776-3860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 7TH ST",
            "address_2": "SUITE 204",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207074003",
            "telephone_number": "301-776-6121",
            "fax_number": "301-776-3860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK PLACE PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-20",
        "last_updated": "2012-09-23",
        "status": "A",
        "authorized_official_last_name": "OBIADI",
        "authorized_official_first_name": "GABRIEL",
        "authorized_official_middle_name": "O",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "301-776-6121",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2012; 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.