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AMBUSH PEDIATRICS AND FAMILY MEDICAL CLINIC
NPI 1457956948
Family Medicine - Adolescent Medicine in Halethorpe, MD

Active since December 02, 2020
4367 HOLLINS FERRY RD STE 1C, HALETHORPE, MD 21227(410) 609-6677(410) 609-6672 Get Directions Write a Review

NPPES record last updated: April 29, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 29, 2026, Apr 7, 2026, Dec 2, 2020 (3 updates tracked since 2020).

About Ambush Pediatrics And Family Medical Clinic NPPES

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

AMBUSH PEDIATRICS AND FAMILY MEDICAL CLINIC (NPI 1457956948) is a healthcare organization registered as an adolescent medicine in Halethorpe, Maryland and active in the NPI registry since December 2020. The organization maintains a secondary practice location in Houston and lists Jacqueline Ebony Ambush, Owner/operator, as its authorized official.

NPPES Registry Identity

NPI1457956948
Entity TypeOrganization
Primary Taxonomy207QA0000X
Legal Business NameAMBUSH PEDIATRICS AND FAMILY MEDICAL CLINIC
Location Address4367 HOLLINS FERRY RD STE 1CHalethorpe, MD 21227-3400
Mailing Address4367 Hollins Ferry Rd Ste 1cHalethorpe, MD 21227-3400 · (410) 609-6677 · Fax (410) 609-6672
Phone(410) 609-6677
Fax(410) 609-6672
Organization SubpartNo
Authorized OfficialJacqueline Ebony AmbushOwner/operator · (410) 707-5947
Enumeration DateDecember 2, 2020
Last NPPES UpdateApril 29, 20263 updates tracked since enumeration
NPPES CertifiedApril 29, 2026
✔ NPI 1457956948 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily Medicine · Adolescent MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207QA0000X
Definition
A family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs.
Also ListedClinic/Center · Health ServiceTaxonomy 261QH0100X
4367 HOLLINS FERRY RD STE 1C, Halethorpe, MD 21227
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Other Names 1

Doing Business AsAmbush Pediatrics And Family Medical Clinic

Secondary Practice Location 1

Location 15252 Hollister St Ste 203CHouston, TX 77040-6214 · Phone (346) 678-4442

Other Identifiers 2

Medicaid999223500MD
Medicaid080454100MD

Other Providers at the Same Location NPPES

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

AMBUSH LAB
Family Medicine (Adolescent Medicine)
4367 HOLLINS FERRY RD STE 1C
BALTIMORE, MD 21227
Baltimore County (410) 707-5947

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 Ambush Pediatrics And Family Medical Clinic's NPI number?

The NPI number for Ambush Pediatrics And Family Medical Clinic is 1457956948. It was assigned to this organization in the NPPES registry on December 2, 2020.

Where is Ambush Pediatrics And Family Medical Clinic located?

Ambush Pediatrics And Family Medical Clinic is located at 4367 Hollins Ferry Rd Ste 1C, Halethorpe, MD 21227. The listed phone number is (410) 609-6677.

What is Ambush Pediatrics And Family Medical Clinic's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Adolescent Medicine, with taxonomy code 207QA0000X.

When was this NPI record last updated?

The NPPES record for Ambush Pediatrics And Family Medical Clinic was last updated on April 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.