NPIMap

Organization Active NPI

Healthport

  • Primary Care Clinic/Center
  • Salisbury, MD
National Provider Identifier
1780950725
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
HEALTHPORT
Practice address
505 E Main St
Salisbury, MD 21804-5020
Phone
(410) 341-3420
Fax
(410) 341-3397
NPI assigned
Mar 23, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

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

Authorized official

Name
Kristine Gartlitz
Title
Vice President
Phone
(410) 202-2651

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

505 E Main St
Salisbury, MD 21804-5020

Mailing address

505 E Main St
Salisbury, MD 21804-5020
Phone (410) 341-3420

Other practice location 1

505 E Main St
Salisbury, MD 21804-5020
Phone (410) 341-3420 ext. 136

Other practice location 2

828 Airpax Rd Ste 600B
Cambridge, MD 21613-6401
Phone (410) 341-3420

Other practice location 3

7033 Worcester Hwy
Newark, MD 21841-2149
Phone (410) 341-3420

Other practice location 4

11559 Somerset Ave
Princess Anne, MD 21853-1067
Phone (410) 341-3420

Other identifiers 1

IdentifierTypeStateIssuer
335475000MedicaidMD

Other names 1

  • Lower Shore Clinic, Inc Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051102000426 MD Part B Supplier - Clinic/Group Practice 2365469947 Receives reassigned benefits from 15 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Newark, MD; Salisbury, MD; Princess Anne, MD; Cambridge, MD

Other NPIs on the same Medicare enrollment 7

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Lower Shore Clinic Inc15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

Locations

11559 Somerset Ave
Princess Anne, MD 21853
Phone (410) 334-6961

Practitioners & affiliated clinicians

Practitioners 6

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": "1332460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741046400000",
    "number": "1780950725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 E MAIN ST",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218045020",
            "telephone_number": "410-341-3420",
            "fax_number": "410-341-3397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 E MAIN ST",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218045020",
            "telephone_number": "410-341-3420",
            "fax_number": "410-341-3397"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "505 E Main St",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "MD",
            "postal_code": "218045020",
            "country_code": "US",
            "telephone_number": "410-341-3420 x136",
            "fax_number": "410-341-3397",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "828 Airpax Rd Ste 600B",
            "address_purpose": "LOCATION",
            "city": "Cambridge",
            "state": "MD",
            "postal_code": "216136401",
            "country_code": "US",
            "telephone_number": "410-341-3420",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7033 Worcester Hwy",
            "address_purpose": "LOCATION",
            "city": "Newark",
            "state": "MD",
            "postal_code": "218412149",
            "country_code": "US",
            "telephone_number": "410-341-3420",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11559 Somerset Ave",
            "address_purpose": "LOCATION",
            "city": "Princess Anne",
            "state": "MD",
            "postal_code": "218531067",
            "country_code": "US",
            "telephone_number": "410-341-3420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HEALTHPORT",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-23",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-03",
        "status": "A",
        "authorized_official_last_name": "GARTLITZ",
        "authorized_official_first_name": "KRISTINE",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "410-202-2651"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "335475000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lower Shore Clinic, Inc",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Salisbury, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; 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.