NPIMap

Organization Active NPI

Fitzgerald Primary Care LLC

  • Primary Care Clinic/Center
  • Baltimore, MD
National Provider Identifier
1902382252
Registry record updated May 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
FITZGERALD PRIMARY CARE LLC
Practice address
2232 E Monument St
Baltimore, MD 21205-2431
Phone
(667) 207-3552
NPI assigned
Jul 18, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2024

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

Authorized official

Name
Mrs. Tarnisha FitzgeraldNPI 1164940656
Title
Sole Proprietor
Phone
(443) 763-7154

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 2

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

Addresses

Primary practice location

2232 E Monument St
Baltimore, MD 21205-2431

Mailing address

2232 E Monument St
Baltimore, MD 21205-2431
Phone (667) 207-3552

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180802001242 MD Part B Supplier - Clinic/Group Practice 7214285592 Receives reassigned benefits from 5 practitioners
1 other NPI on this enrollment
Practice locations: Lutherville, MD; Baltimore, MD

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory
Tax ID family
Fitzgerald Primary Care LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

7952 Harford Rd
Ste Bc
Parkville, MD 21234

Practitioners & affiliated clinicians

Practitioners 5

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": "1531872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715817600000",
    "number": "1902382252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2232 E MONUMENT ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212052431",
            "telephone_number": "667-207-3552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2232 E MONUMENT ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212052431",
            "telephone_number": "667-207-3552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FITZGERALD PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-18",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A",
        "authorized_official_last_name": "FITZGERALD",
        "authorized_official_first_name": "TARNISHA",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "443-763-7154",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; 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.