1609195320 NPI number — JOHNS HOPKINS REGIONAL PHYSICIANS LLC

Table of content: (NPI 1609195320)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609195320 NPI number — JOHNS HOPKINS REGIONAL PHYSICIANS LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JOHNS HOPKINS REGIONAL PHYSICIANS LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1609195320
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/20/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 412709
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BOSTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02241-2709
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-760-8840
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10710 CHARTER DR
Provider Second Line Business Practice Location Address:
STE 400
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21044
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
443-276-9000
Provider Business Practice Location Address Fax Number:
443-276-9610
Provider Enumeration Date:
05/20/2010

Additional Information

Authorized Official

Authorized Official Last Name:
MARTUCCI
Authorized Official First Name:
KRISTI
Authorized Official Middle Name:
Authorized Official Title or Position:
JHRP BILLING MANAGER
Authorized Official Telephone Number:
410-760-8840

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207RC0001X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RI0011X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: CRZ1CA . This is a "CAREFIRST OF MARYLAND" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: V879 . This is a "CAREFIRST GHMSI AND BLUE CHOICE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 440200600 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: DR1793 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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