NPIMap

Individual provider Active NPI

Paul M. Ettlinger, DC

  • Chiropractor
  • Owings Mills, MD
National Provider Identifier
1912900770
Registry record updated Mar 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
S01788 Issued in MD
Practice address
7920 McDonogh Rd
Suite 101
Owings Mills, MD 21117-5249
Phone
(410) 356-9939
Fax
(410) 356-9987
NPI assigned
May 24, 2005
Last updated
Mar 1, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 01788 MD
Chiropractor 111N00000X S01788 MD Primary

Addresses

Primary practice location

7920 McDonogh Rd
Suite 101
Owings Mills, MD 21117-5249

Mailing address

7920 McDonogh Road
Suite 101
Owings Mills, MD 21117-5249
Phone (410) 356-9939

Other identifiers 1

IdentifierTypeStateIssuer
216603800MedicaidMD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040727001290 MD Practitioner - Chiropractic 3971573080 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Health Quest Chiropractic and Physical Therapy, LLCGroup PAC ID 9830122738, 7 clinicians

Practice addresses (Care Compare)

320 W 29TH St
Suite 100
Baltimore, MD 21211-2909
Phone (443) 529-0441

7920 McDonogh Rd
Suite 101
Owings Mills, MD 21117-5249
Phone (410) 356-9939

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
01788MDMDClinical Psychologist
S01788MDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Health Quest Chiropractic & Physical Therapy, LLC Chiropractor CurrentSince Jan 1, 2005 Accepting new patients

Locations

320 W 29th St
Ste 10
Baltimore, MD 21211
Phone (443) 529-0441

6427 Baltimore National Pike
Ste B
Catonsville, MD 21228
Phone (410) 801-9579

1300 York Rd
Ste 149
Lutherville, MD 21093
Phone (410) 823-8888

8007 Corporate Dr
Ste F
Nottingham, MD 21236
Phone (410) 657-5770

10995 Owings Mills Blvd
Ste 200
Owings Mills, MD 21117
Phone (410) 356-9939

7920 McDonogh Rd
Ste 101
Owings Mills, MD 21117
Phone (410) 356-9939

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330560000000",
    "number": "1912900770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7920 MCDONOGH ROAD",
            "address_2": "SUITE 101",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175249",
            "telephone_number": "410-356-9939",
            "fax_number": "410-356-9987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7920 MCDONOGH RD",
            "address_2": "SUITE 101",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211175249",
            "telephone_number": "410-356-9939",
            "fax_number": "410-356-9987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETTLINGER",
        "first_name": "PAUL",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2012-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "01788",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "S01788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "216603800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Owings Mills, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.