NPIMap

Organization Active NPI

Rosedale Primary Care Physician, P.C.

  • Specialist
  • Rosedale, MD
National Provider Identifier
1972951440
Registry record updated May 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
D0076990 Issued in MD
Legal business name
ROSEDALE PRIMARY CARE PHYSICIAN, P.C.
Practice address
19 Fontana LN
Suite 108-110
Rosedale, MD 21237-3047
Phone
(410) 218-5523
NPI assigned
May 25, 2016
Last updated
May 25, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2016

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

Authorized official

Name
Dr. Xiaofei Li
Title
Resident Agent
Phone
(410) 218-5523

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X D0076990 MD Primary

Addresses

Primary practice location

19 Fontana LN
Suite 108-110
Rosedale, MD 21237-3047

Mailing address

540 Montclair CT
Parkton, MD 21120-9801
Phone (410) 218-5523

National Provider Directory

National Provider Directory

Locations

19 Fontana Ln
Ste 108110
Rosedale, MD 21237
Phone (410) 218-5523

Practitioners & affiliated clinicians

Practitioners 1

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": "1464134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1464134400000",
    "number": "1972951440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 MONTCLAIR CT",
            "city": "PARKTON",
            "state": "MD",
            "postal_code": "211209801",
            "telephone_number": "410-218-5523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 FONTANA LN",
            "address_2": "SUITE 108-110",
            "city": "ROSEDALE",
            "state": "MD",
            "postal_code": "212373047",
            "telephone_number": "410-218-5523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSEDALE PRIMARY CARE PHYSICIAN, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-25",
        "last_updated": "2016-05-25",
        "status": "A",
        "authorized_official_last_name": "LI",
        "authorized_official_first_name": "XIAOFEI",
        "authorized_official_title_or_position": "RESIDENT AGENT",
        "authorized_official_telephone_number": "410-218-5523",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MD",
            "license": "D0076990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rosedale, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 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.