Pace & Leatherwood, PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PACE & LEATHERWOOD, PC

Practice address

12070 Old Line Ctr
Suite 302
Waldorf, MD 20602-2513

Phone

(301) 645-6667

Fax

(301) 870-9722

NPI assigned

Mar 10, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Tammy M Breitenbach, CMM

Title

Medical Manager

Phone

(301) 645-6667

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1141948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207785600000",
    "number": "1912975277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 249",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206040249",
            "telephone_number": "301-645-6667",
            "fax_number": "301-870-9722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12070 OLD LINE CTR",
            "address_2": "SUITE 302",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206022513",
            "telephone_number": "301-645-6667",
            "fax_number": "301-870-9722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PACE & LEATHERWOOD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-10",
        "last_updated": "2008-04-10",
        "status": "A",
        "authorized_official_last_name": "BREITENBACH",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MEDICAL MANAGER",
        "authorized_official_telephone_number": "301-645-6667",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "CMM"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "371231100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jordan Owens
• Lakitha Owens, PHD
• Zelinda Yvonne Owens, PTA
• Margaret Owusu
• Yaminellie Pabon
• Robert Timothy Pace, MD
• Paden & Associates, Incorporated
• Paden-Life-Care LLC
• Golzar Pahlevani
• Gregory Alfred Palmer, CAC-AD/S, CAC II

• Family Medicine Physician in Waldorf, MD
• Providers in Waldorf, MD by specialty
• Family Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 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.