1. Home
  2. Directory
  3. Maryland
  4. Lexington Park
  5. General Practice
  6. NPI Profile

PAX RIVER MEDICAL CLINIC, LLC
NPI 1083807085
General Practice in Lexington Park, MD

Active since August 22, 2007
46940 S SHANGRI LA DR, SUITE #19, LEXINGTON PARK, MD 20653(301) 863-8101(301) 863-8130 Get Directions Write a Review

NPPES record last updated: May 9, 2014. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Pax River Medical Clinic, Llc NPPES

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

PAX RIVER MEDICAL CLINIC, LLC (NPI 1083807085) is a healthcare organization registered as a general practice in Lexington Park, Maryland and active in the NPI registry since August 2007. The organization lists Katherine Ann Martin, Owner, as its authorized official.

NPPES Registry Identity

NPI1083807085
Entity TypeOrganization
Primary Taxonomy208D00000X
Legal Business NamePAX RIVER MEDICAL CLINIC, LLC
Location Address46940 S SHANGRI LA DR, SUITE #19Lexington Park, MD 20653-1037
Mailing Address46940 S Shangri La Dr, Suite #19Lexington Park, MD 20653-1037 · (301) 863-8101 · Fax (301) 863-8130
Phone(301) 863-8101
Fax(301) 863-8130
Organization SubpartNo
Authorized OfficialKatherine Ann MartinOwner · (301) 863-8101
Enumeration DateAugust 22, 2007
Last NPPES UpdateMay 9, 2014
✔ NPI 1083807085 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in MD · H0055958
Definition

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee

46940 S SHANGRI LA DR, Lexington Park, MD 20653
Open in Google Maps ↗

Other Identifiers 4

Medicaid011218600MD
Medicare PIN479PDC
Other1437267986MD · Individual Npi #
Medicare PINC64558MD

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

TRICO CORPORATION
Counselor (Mental Health)
46940 S SHANGRI LA DR
LEXINGTON PARK, MD 20653
St. Mary's County (301) 862-4961
DR. KATHERINE A MARTIN DO
Family Medicine
46940 S SHANGRI LA DR, SUITE 19
LEXINGTON PARK, MD 20653
St. Mary's County (301) 863-8101
MS. CLARA E MUSSER LCSW-C
Social Worker
46940 S SHANGRI LA DR, SUITE 15
LEXINGTON PARK, MD 20653
St. Mary's County (301) 863-4543
TRICO CLINICAL SERVICES LTD
Respite Care (Respite Care, Mental Illness, Child)
46940 S SHANGRI LA DR, SUITE 10
LEXINGTON PARK, MD 20653
St. Mary's County (301) 862-4961

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 Pax River Medical Clinic, LLC's NPI number?

The NPI number for Pax River Medical Clinic, LLC is 1083807085. It was assigned to this organization in the NPPES registry on August 22, 2007.

Where is Pax River Medical Clinic, LLC located?

Pax River Medical Clinic, LLC is located at 46940 S Shangri La Dr Suite #19, Lexington Park, MD 20653. The listed phone number is (301) 863-8101.

What is Pax River Medical Clinic, LLC's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

When was this NPI record last updated?

The NPPES record for Pax River Medical Clinic, LLC was last updated on May 9, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.