NPIMap

Organization Active NPI

Little Doc Rider PC

  • Family Medicine Physician
  • Berlin, MD
National Provider Identifier
1922168947
Registry record updated Dec 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
LITTLE DOC RIDER PC
Practice address
314 Franklin Ave
Suite 403
Berlin, MD 21811-1215
Phone
(410) 629-1995
Fax
(410) 629-1993
NPI assigned
Dec 11, 2006
Last updated
Dec 10, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2009

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

Authorized official

Name
Brookellen Rider, DONPI 1326036617
Title
Proprietor
Phone
(410) 629-1995

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

314 Franklin Ave
Suite 403
Berlin, MD 21811-1215

Mailing address

PO Box 1578
Berlin, MD 21811-5578
Phone (410) 641-9450

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260403200000",
    "number": "1922168947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1578",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218115578",
            "telephone_number": "410-641-9450",
            "fax_number": "410-641-9515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 FRANKLIN AVE",
            "address_2": "SUITE 403",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218111215",
            "telephone_number": "410-629-1995",
            "fax_number": "410-629-1993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLE DOC RIDER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2009-12-10",
        "status": "A",
        "authorized_official_last_name": "RIDER",
        "authorized_official_first_name": "BROOKELLEN",
        "authorized_official_title_or_position": "PROPRIETOR",
        "authorized_official_telephone_number": "410-629-1995",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berlin, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2009; 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.