NPIMap

Organization Active NPI

Central Maryland Cardiology, P.a.

  • Cardiovascular Disease Physician
  • Baltimore, MD
National Provider Identifier
1922036524
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
Legal business name
CENTRAL MARYLAND CARDIOLOGY, P.A.
Practice address
5601 Loch Raven Blvd
Fourth Floor
Baltimore, MD 21239-2905
Phone
(410) 532-4205
Fax
(410) 532-4216
NPI assigned
Jun 30, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Jelles N Fonda, M.D.NPI 1841269651
Title
President
Phone
(410) 532-4205

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X NU Primary

Addresses

Primary practice location

5601 Loch Raven Blvd
Fourth Floor
Baltimore, MD 21239-2905

Mailing address

5601 Loch Raven Blvd
Fourth Floor
Baltimore, MD 21239-2905
Phone (410) 532-4205

Other identifiers 1

IdentifierTypeStateIssuer
CN0298OtherMDPALMETTO GBA

National Provider Directory

National Provider Directory

Locations

5601 Loch Raven Blvd
Fl 4
Baltimore, MD 21239
Phone (410) 578-8702

5601 Loch Raven Blvd
Fl Fourth
Baltimore, MD 21239
Phone (410) 532-4205

5601 Loch Raven Blvd
Ste 301
Baltimore, MD 21239
Phone (443) 444-4536

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1922036524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5601 LOCH RAVEN BLVD",
            "address_2": "FOURTH FLOOR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212392905",
            "telephone_number": "410-532-4205",
            "fax_number": "410-532-4216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 LOCH RAVEN BLVD",
            "address_2": "FOURTH FLOOR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212392905",
            "telephone_number": "410-532-4205",
            "fax_number": "410-532-4216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL MARYLAND CARDIOLOGY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FONDA",
        "authorized_official_first_name": "JELLES",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-532-4205",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA",
            "identifier": "CN0298",
            "state": "MD"
        }
    ],
    "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 Aug 22, 2020; 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.