NPIMap

Organization Active NPI

Charles J. Lancelotta Jr., M.D., P.a.

  • Specialist
  • Columbia, MD
National Provider Identifier
1902075997
Registry record updated Feb 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
D0009071 Issued in MD
Legal business name
CHARLES J. LANCELOTTA JR., M.D., P.A.
Practice address
11055 Little Patuxent Pkwy
Suite L7
Columbia, MD 21044-2896
Phone
(410) 715-2533
Fax
(410) 715-2536
NPI assigned
Feb 25, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2008

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

Authorized official

Name
Dr. Charles Joseph Lancelotta Jr., M.D.
Title
Owner
Phone
(410) 715-2533

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X D0009071 MD Primary

Addresses

Primary practice location

11055 Little Patuxent Pkwy
Suite L7
Columbia, MD 21044-2896

Mailing address

11085 Little Patuxent Pkwy
Suite LL-007
Columbia, MD 21044-2983
Phone (410) 715-2533

National Provider Directory

National Provider Directory

Locations

3421 Benson Ave
Ste 350
Baltimore, MD 21227
Phone (410) 646-3993

3449 Wilkens Ave
Ste 204
Baltimore, MD 21229
Phone (410) 368-8323

11085 Little Patuxent Pkwy
Ste LL007
Columbia, MD 21044
Phone (410) 715-2533

11055 Little Patuxent Pkwy
Ste L7
Columbia, MD 21044
Phone (410) 715-2533

Practitioners & affiliated clinicians

Practitioners 4

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": "1203897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203897600000",
    "number": "1902075997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11085 LITTLE PATUXENT PKWY",
            "address_2": "SUITE LL-007",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210442983",
            "telephone_number": "410-715-2533",
            "fax_number": "410-715-2536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11055 LITTLE PATUXENT PKWY",
            "address_2": "SUITE L7",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210442896",
            "telephone_number": "410-715-2533",
            "fax_number": "410-715-2536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES J. LANCELOTTA JR., M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-25",
        "last_updated": "2008-02-25",
        "status": "A",
        "authorized_official_last_name": "LANCELOTTA",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-715-2533",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MD",
            "license": "D0009071",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2008; 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.