Pelican Medical Group, LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

PELICAN MEDICAL GROUP, LLC

Practice address

3706 Crondall LN Ste 105B
Owings Mills, MD 21117-2243

Phone

(410) 303-9923

NPI assigned

Jun 3, 2019

Organization subpart

No

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

Authorized official

Name

Rodney Blockston

Title

Director

Phone

(410) 303-9923

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1559520000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613606400000",
    "number": "1831757111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10019 REISTERSTOWN RD STE 203",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211173950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3706 CRONDALL LN STE 105B",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211172243",
            "telephone_number": "410-303-9923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PELICAN MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-03",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A",
        "authorized_official_last_name": "BLOCKSTON",
        "authorized_official_first_name": "RODNEY",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "410-303-9923"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alaun Patterson
• William Pawluk, M.D.
• Atara Pear, M.S., CCC-SLP
• Katina Monique Pearce, LCSW-C
• Murray Dennis Pearlman, MD
• Toni Pelingon
• Jodie C Pelusi
• Matthew Peragine, MS ATC LAT PES CES
• Tylesha Perkins
• Levi Perlman

• Clinical Medical Laboratory in Owings Mills, MD
• Providers in Owings Mills, MD by specialty
• Clinical Medical Laboratory in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2021; 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.