NPIMap

Organization Active NPI

Kennedy Krieger Children'S Hospital, Inc.

  • Developmental Disabilities Clinic/Center
  • Columbia, MD
National Provider Identifier
1992513030
Registry record updated Dec 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Developmental Disabilities Clinic/CenterTaxonomy code 261QD1600X
Legal business name
KENNEDY KRIEGER CHILDREN'S HOSPITAL, INC.
Practice address
9730 Patuxent Woods Dr
Columbia, MD 21046-1506
Phone
(443) 923-1815
NPI assigned
Dec 20, 2024
Organization subpart
Yes
Parent organization
KENNEDY KRIEGER CHILDREN'S HOSPITAL, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 20, 2024

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

Authorized official

Name
Lisa Badie
Title
Vice President Finance
Phone
(443) 923-1812

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Disabilities Clinic/Center 261QD1600X Primary
Children's Chronic Disease Hospital 281PC2000X
Long Term Care Hospital 282E00000X
Psychiatric Hospital 283Q00000X
Rehabilitation Hospital 283X00000X
Children's Rehabilitation Hospital 283XC2000X
Special Hospital 284300000X
Clinical Medical Laboratory 291U00000X

Addresses

Primary practice location

9730 Patuxent Woods Dr
Columbia, MD 21046-1506

Mailing address

PO Box 45944
Baltimore, MD 21297-5944
Phone (443) 923-1886

Other identifiers 3

IdentifierTypeStateIssuer
59351301OtherMDID
MD9OtherMDID
955675300MedicaidMD

Other names 1

  • KENNEDY KRIEGER INSTITUTE Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090831000534 MD Part A Provider - Hospital 5496762825 13 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Columbia, MD; Odenton, MD; Middle River, MD; Fulton, MD; Baltimore, MD

Hospital certification: CCN 213301

Legal name
KENNEDY KRIEGER CHILDRENS HOSPITAL INC
Doing business as
KENNEDY KRIEGER INSTITUTE
Certification status
Active
Provider type (POS)
Hospital – Children’s
Participating since
Jul 1, 1988
Last certification
May 3, 1989
Beds
63
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
Sep 17, 1937 in MD
Enrollment address
707 North Broadway
Baltimore, MD 21205-1832
Main/Primary Hospital Location
Hospital subgroups
Children’s

Other NPIs on the same Medicare enrollment 13

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 13

Care Compare: Hospital

Medicare Care Compare
Listed as
Kennedy Krieger InstituteCCN 213301
Type
Childrens
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Kennedy Krieger Childrens Hospital Inc19 organizations share this tax ID, including this one
Part of
Kennedy Krieger Childrens Hospital Inc

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

Locations

9730 Patuxent Woods Dr
Columbia, MD 21046
Phone (443) 923-1815

Ownership & related parties

All disclosed owners & managing parties 8

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Bank of America, N.a. Organization, Baltimore, MD Created for acquisition, Financial institution 5% Or Greater Mortgage Interest Jun 1, 2011 15%
James M Anders Individual Corporate OfficerExecutive Vice President Coo Nov 18, 1986
Lisa Badie Individual 5% Or Greater Indirect Ownership Interest Nov 13, 2024
W-2 Managing EmployeeVP, Finance Nov 13, 2024
Bradley L Schlaggar Individual Corporate OfficerPresident, Chief Executive Officer Aug 1, 2018 100%
Truist Organization, Baltimore, MD Created for acquisition, Financial institution 5% Or Greater Mortgage Interest Dec 1, 2010 10%
Kennedy Krieger Institute Organization, Baltimore, MD Created for acquisition, Corporation, Non-profit 5% Or Greater Direct Ownership Interest Dec 1, 1986 100%
Joann Kubica Individual W-2 Managing EmployeeVP, Revenue Cycle Integrity Feb 1, 2020 1%
Michael Neuman Individual Corporate OfficerSenior Vice President Cfo Feb 5, 1990
Operational/Managerial ControlSenior Vice President Cfo Feb 5, 1990

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Affiliated clinicians 58

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 58

NPI Registry JSON

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

{
    "created_epoch": "1734652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734652800000",
    "number": "1992513030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 45944",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212975944",
            "telephone_number": "443-923-1886",
            "fax_number": "443-923-1875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9730 PATUXENT WOODS DR",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210461506",
            "telephone_number": "443-923-1815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNEDY KRIEGER CHILDREN'S HOSPITAL, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "KENNEDY KRIEGER CHILDREN'S HOSPITAL, INC.",
        "enumeration_date": "2024-12-20",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A",
        "authorized_official_last_name": "BADIE",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "VICE PRESIDENT FINANCE",
        "authorized_official_telephone_number": "443-923-1812"
    },
    "taxonomies": [
        {
            "code": "261QD1600X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "281PC2000X",
            "taxonomy_group": "",
            "desc": "Chronic Disease Hospital, Children",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "283Q00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "283XC2000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital, Children",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "284300000X",
            "taxonomy_group": "",
            "desc": "Special Hospital",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ID",
            "identifier": "59351301",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ID",
            "identifier": "MD9",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "955675300",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KENNEDY KRIEGER INSTITUTE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbia, MD

Sources for this page

Verify at the official NPI Registry.