The Peterkin Group of Maryland

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

THE PETERKIN GROUP OF MARYLAND

Practice address

9033 Poplar Rd
Berlin, MD 21811-2949

Phone

(910) 476-2796

Fax

(843) 454-1283

NPI assigned

Jul 6, 2016

Organization subpart

No

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

Authorized official

Name

Barbara Ann Little, MHQP

Title

Executive Director

Phone

(910) 476-2796

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1467763200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467763200000",
    "number": "1942652615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9033 POPLAR RD",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218112949",
            "telephone_number": "910-476-2796",
            "fax_number": "843-454-1283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9033 POPLAR RD",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218112949",
            "telephone_number": "910-476-2796",
            "fax_number": "843-454-1283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PETERKIN GROUP OF MARYLAND",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-06",
        "last_updated": "2016-07-06",
        "status": "A",
        "authorized_official_last_name": "LITTLE",
        "authorized_official_first_name": "BARBARA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "910-476-2796",
        "authorized_official_credential": "MHQP"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2016; 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.