Organization Active NPI

Lisa C. Kates, LLC

  • Medical Specialty Clinic/Center
  • Crofton, MD
National Provider Identifier
1811120488
Registry record updated Aug 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
License
D0063518 Issued in MD
Legal business name
LISA C. KATES, LLC
Practice address
2200 Defense Hwy Ste 201
Crofton, MD 21114-2927
Phone
(410) 451-5500
Fax
(410) 451-5504
NPI assigned
Aug 31, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2009

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

Authorized official

Name
Dr. Lisa Catherine Kates, M.D.NPI 1518935188
Title
President
Phone
(410) 451-5500

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
Medical Specialty Clinic/Center 261QM2500X D0063518 MD Primary

Addresses

Primary practice location

2200 Defense Hwy Ste 201
Crofton, MD 21114-2927

Mailing address

2200 Defense Hwy Ste 201
Crofton, MD 21114-2927
Phone (410) 451-5500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090916000691 MD Part B Supplier - Clinic/Group Practice 1951457993 Receives reassigned benefits from 3 practitioners
Practice locations: Crofton, MD

National Provider Directory

National Provider Directory

Locations

2200 Defense Hwy
Ste 201
Crofton, MD 21114
Phone (410) 451-5500

Practitioners & affiliated clinicians

Practitioners 3

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": "1251676800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1251676800000",
    "number": "1811120488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 DEFENSE HWY STE 201",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211142927",
            "telephone_number": "410-451-5500",
            "fax_number": "410-451-5504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 DEFENSE HWY STE 201",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211142927",
            "telephone_number": "410-451-5500",
            "fax_number": "410-451-5504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA C. KATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-08-31",
        "last_updated": "2009-08-31",
        "status": "A",
        "authorized_official_last_name": "KATES",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "CATHERINE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-451-5500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "MD",
            "license": "D0063518",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crofton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2009; 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.