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CHESAPEAKE PEDIATRIC & ADOLESCENT ASSOCIATES, PA
NPI 1073340907
Pediatrics in Berlin, MD

Active since September 16, 2024CLIA Certified · 2 labs
29 BROAD ST STE 201, BERLIN, MD 21811(410) 543-1616(410) 543-8497 Get Directions Write a Review

NPPES record last updated: September 2, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 2, 2025, Sep 16, 2024 (2 updates tracked since 2024).

About Chesapeake Pediatric & Adolescent Associates, Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CHESAPEAKE PEDIATRIC & ADOLESCENT ASSOCIATES, PA (NPI 1073340907) is a healthcare organization registered as a pediatrics in Berlin, Maryland and active in the NPI registry since September 2024. The organization holds 2 active CLIA laboratory certificates and lists Kim Watson, Credentialing, as its authorized official.

NPPES Registry Identity

NPI1073340907
Entity TypeOrganization
Primary Taxonomy208000000X
Legal Business NameCHESAPEAKE PEDIATRIC & ADOLESCENT ASSOCIATES, PA
Location Address29 BROAD ST STE 201Berlin, MD 21811-1054
Mailing Address106 Milford St Ste 201Salisbury, MD 21804-6959 · (410) 543-1616 · Fax (410) 543-8497
Phone(410) 543-1616
Fax(410) 543-8497
Organization SubpartNo
Authorized OfficialKim WatsonCredentialing · (410) 543-1616
Enumeration DateSeptember 16, 2024
Last NPPES UpdateSeptember 2, 20252 updates tracked since enumeration
NPPES CertifiedSeptember 2, 2025
✔ NPI 1073340907 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
29 BROAD ST STE 201, Berlin, MD 21811
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 21D2138615

Chesapeake Pediatrics & Adolescent Ass, PA · Berlin, MD
Active · expires Oct 22, 2027
CLIA Number21D2138615
Laboratory TypePhysician Office
Certificate Effective DateOctober 23, 2025
Certificate Expiration DateOctober 22, 2027
Laboratory DirectorWilliam C. Taylor MD
Laboratory Phone(410) 543-1616
Laboratory LocationChesapeake Pediatrics & Adolescent Ass, PA29 Broad Street Suite 201, Berlin, MD 21811
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 21D0221161

Chesapeake Pediatrics & Adolescent Assoc PA · Salisbury, MD
Active · expires Feb 22, 2028
CLIA Number21D0221161
Laboratory TypePhysician Office
Certificate Effective DateFebruary 23, 2026
Certificate Expiration DateFebruary 22, 2028
Laboratory DirectorMohan K. Thummalapalli
Laboratory Phone(410) 543-1616
Laboratory LocationChesapeake Pediatrics & Adolescent Assoc PA106 Milford St Ste201, Salisbury, MD 21801
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Chesapeake Pediatric & Adolescent Associates, PA's NPI number?

The NPI number for Chesapeake Pediatric & Adolescent Associates, PA is 1073340907. It was assigned to this organization in the NPPES registry on September 16, 2024.

Where is Chesapeake Pediatric & Adolescent Associates, PA located?

Chesapeake Pediatric & Adolescent Associates, PA is located at 29 Broad St Ste 201, Berlin, MD 21811. The listed phone number is (410) 543-1616.

What is Chesapeake Pediatric & Adolescent Associates, PA's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Does Chesapeake Pediatric & Adolescent Associates, PA hold CLIA laboratory certificates?

Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.

When was this NPI record last updated?

The NPPES record for Chesapeake Pediatric & Adolescent Associates, PA was last updated on September 2, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.