NPIMap

Organization Active NPI

Pediatrix Medical Group of the Mid-Atlantic PC

  • Maternal & Fetal Medicine Physician
  • Hagerstown, MD
National Provider Identifier
1801642863
Registry record updated Nov 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Maternal & Fetal Medicine PhysicianTaxonomy code 207VM0101X
Legal business name
PEDIATRIX MEDICAL GROUP OF THE MID-ATLANTIC PC
Practice address
11110 Medical Campus Rd Ste 107
Hagerstown, MD 21742-6734
Phone
(301) 714-4100
NPI assigned
Apr 29, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2024

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

Authorized official

Name
Nicholas E. Glaser
Title
Assistant Secretary
Phone
(954) 384-0175

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Maternal & Fetal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VM0101X Primary

Addresses

Primary practice location

11110 Medical Campus Rd Ste 107
Hagerstown, MD 21742-6734

Mailing address

PO Box 100445
Atlanta, GA 30384-0445
Phone (954) 384-0175

Other identifiers 1

IdentifierTypeStateIssuer
287003705MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
Pediatrix Medical Group of the Mid-Atlantic PC31 organizations share this tax ID, including this one

Other organizations with this tax ID 30

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

View all 30

NPI Registry JSON

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

{
    "created_epoch": "1714348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730678400000",
    "number": "1801642863",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100445",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303840445",
            "telephone_number": "954-384-0175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11110 MEDICAL CAMPUS RD STE 107",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "217426734",
            "telephone_number": "301-714-4100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIX MEDICAL GROUP OF THE MID-ATLANTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-29",
        "last_updated": "2024-11-04",
        "certification_date": "2024-11-04",
        "status": "A",
        "authorized_official_last_name": "GLASER",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "ASSISTANT SECRETARY",
        "authorized_official_telephone_number": "954-384-0175"
    },
    "taxonomies": [
        {
            "code": "207VM0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Maternal & Fetal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "287003705",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hagerstown, MD

Sources for this page

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

Verify at the official NPI Registry.