The Pediatric Center of Frederick, LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

THE PEDIATRIC CENTER OF FREDERICK, LLC

Practice address

1475 Taney Ave
Ste 201
Frederick, MD 21702-4747

Phone

(301) 631-8053

Fax

(301) 695-8604

NPI assigned

Mar 21, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Jennifer M Vanpelt

Title

Front Office Coordinator

Phone

(301) 631-8053

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1395360000000",
    "number": "1952427072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1475 TANEY AVE",
            "address_2": "STE 201",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024747",
            "telephone_number": "301-631-8053",
            "fax_number": "301-695-8604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1475 TANEY AVE",
            "address_2": "STE 201",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024747",
            "telephone_number": "301-631-8053",
            "fax_number": "301-695-8604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE PEDIATRIC CENTER OF FREDERICK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2014-03-21",
        "status": "A",
        "authorized_official_last_name": "VANPELT",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "FRONT OFFICE COORDINATOR",
        "authorized_official_telephone_number": "301-631-8053",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "218841400",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Pediatrics Physician in Frederick, MD
• Providers in Frederick, MD by specialty
• Pediatrics Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.