Shady Grove Pediatric Associates

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

SHADY GROVE PEDIATRIC ASSOCIATES

Practice address

15215 Shady Grove Rd
Suite 303
Rockville, MD 20850-3235

Phone

(301) 330-3216

Fax

(301) 330-0026

NPI assigned

Oct 4, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Carol Ann Plotsky, MD

Title

Owner President

Phone

(301) 330-3216

Specialties & licenses 1

Addresses

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

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lindsey Celia Peller, D.O.

  • Pediatrics Physician
  • Columbia, SC
  • NPI 1386094605
  NPD (past)

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962597021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15215 SHADY GROVE ROAD",
            "address_2": "SUITE 303",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "20850",
            "telephone_number": "301-330-3216",
            "fax_number": "301-330-0026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15215 SHADY GROVE RD",
            "address_2": "SUITE 303",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503235",
            "telephone_number": "301-330-3216",
            "fax_number": "301-330-0026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADY GROVE PEDIATRIC ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PLOTSKY",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "301-330-3216",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shady Grove Eye & Vision Care, LLC
• Shady Grove Family Health Care Inc
• Shady Grove Fertility Reproductive Science Center
• Shady Grove Hyperbaric Medicine
• Shady Grove Orthopaedic Assoc, PA
• Shady Grove Reproductive Science Center PC
• Shady Grove SNF LLC
• Shady Grove SNF LLC
• Shady Grove SNF LLC
• Shady Grove SNF LLC

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

• 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.
• 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.