NPIMap

Organization Active NPI

Crisfield Clinic, LLC

  • Family Nurse Practitioner
  • Salisbury, MD
National Provider Identifier
1962768655
Registry record updated Apr 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R105366 Issued in MD
Legal business name
CRISFIELD CLINIC, LLC
Practice address
6062 Bridle CT
Salisbury, MD 21801-1715
Phone
(443) 493-0062
NPI assigned
Apr 6, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2012

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

Authorized official

Name
Dr. Kerry Colleen Palakanis, CRNPNPI 1841466810
Title
Owner
Phone
(443) 493-0062

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 Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X R105366 MD Primary

Addresses

Primary practice location

6062 Bridle CT
Salisbury, MD 21801-1715

Mailing address

4384 Crisfield Hwy
Crisfield, MD 21817-2550
Phone (443) 493-0062

National Provider Directory

National Provider Directory

Locations

4384 Crisfield Hwy
Crisfield, MD 21817
Phone (410) 749-5050

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1333670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1333670400000",
    "number": "1962768655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4384 CRISFIELD HWY",
            "city": "CRISFIELD",
            "state": "MD",
            "postal_code": "218172550",
            "telephone_number": "443-493-0062",
            "fax_number": "443-782-0076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6062 BRIDLE CT",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218011715",
            "telephone_number": "443-493-0062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRISFIELD CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-06",
        "last_updated": "2012-04-06",
        "status": "A",
        "authorized_official_last_name": "PALAKANIS",
        "authorized_official_first_name": "KERRY",
        "authorized_official_middle_name": "COLLEEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-493-0062",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R105366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salisbury, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2012; 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.