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  7. NPI Record 1750388112

CHESAPEAKE PODIATRY GROUP, P.A.
Complete NPI Record 1750388112
Podiatrist in Westminster, MD

NPI Status: Active since June 30, 2005

Contact Information

910 WASHINGTON RD STE D
WESTMINSTER, MD
ZIP 21157
Phone: (410) 876-8637
Fax: (410) 857-5273

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Employer Identification Number EIN
  4. Provider Organization Name Legal Business Name
  5. Provider First Line Business Mailing Address
  6. Provider Business Mailing Address City Name
  7. Provider Business Mailing Address State Name
  8. Provider Business Mailing Address Postal Code
  9. Provider Business Mailing Address Country Code If outside U S
  10. Provider Business Mailing Address Telephone Number
  11. Provider Business Mailing Address Fax Number
  12. Provider First Line Business Practice Location Address
  13. Provider Business Practice Location Address City Name
  14. Provider Business Practice Location Address State Name
  15. Provider Business Practice Location Address Postal Code
  16. Provider Business Practice Location Address Country Code If outside U S
  17. Provider Business Practice Location Address Telephone Number
  18. Provider Business Practice Location Address Fax Number
  19. Provider Enumeration Date
  20. Last Update Date
  21. Authorized Official Last Name
  22. Authorized Official First Name
  23. Authorized Official Middle Name
  24. Authorized Official Title or Position
  25. Authorized Official Telephone Number
  26. Healthcare Provider Taxonomy Code 1
  27. Provider License Number 1
  28. Provider License Number State Code 1
  29. Healthcare Provider Primary Taxonomy Switch 1
  30. Other Provider Identifier 1
  31. Other Provider Identifier Type Code 1
  32. Other Provider Identifier Issuer 1
  33. Other Provider Identifier 2
  34. Other Provider Identifier Type Code 2
  35. Other Provider Identifier Issuer 2
  36. Other Provider Identifier 3
  37. Other Provider Identifier Type Code 3
  38. Other Provider Identifier Issuer 3
  39. Other Provider Identifier 4
  40. Other Provider Identifier Type Code 4
  41. Other Provider Identifier State 4
  42. Other Provider Identifier Issuer 4
  43. Other Provider Identifier 5
  44. Other Provider Identifier Type Code 5
  45. Other Provider Identifier State 5
  46. Other Provider Identifier 6
  47. Other Provider Identifier Type Code 6
  48. Other Provider Identifier Issuer 6
  49. Other Provider Identifier 7
  50. Other Provider Identifier Type Code 7
  51. Other Provider Identifier Issuer 7
  52. Other Provider Identifier 8
  53. Other Provider Identifier Type Code 8
  54. Other Provider Identifier Issuer 8
  55. Other Provider Identifier 9
  56. Other Provider Identifier Type Code 9
  57. Other Provider Identifier Issuer 9
  58. Other Provider Identifier 10
  59. Other Provider Identifier Type Code 10
  60. Other Provider Identifier Issuer 10
  61. Other Provider Identifier 11
  62. Other Provider Identifier Type Code 11
  63. Other Provider Identifier Issuer 11
  64. Other Provider Identifier 12
  65. Other Provider Identifier Type Code 12
  66. Other Provider Identifier State 12
  67. Other Provider Identifier Issuer 12
  68. Is Organization Subpart
  69. Authorized Official Name Prefix Text
  70. Authorized Official Credential Text
  71. Healthcare Provider Taxonomy Group 1

Complete NPI Dataset

This page represents the complete record for NPI 1750388112. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1750388112
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 2
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EIN: UNAVAIL
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider First Line Business Mailing Address: 910 WASHINGTON RD STE D
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City Name: WESTMINSTER
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: MD
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 211575845
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 4108768637
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Provider Business Mailing Address Fax Number: 4108575273
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider First Line Business Practice Location Address: 910 WASHINGTON RD STE D
The last name of the provider. If the provider is an individual, this is the legal name.
Provider Business Practice Location Address City Name: WESTMINSTER
The first name of the provider, if the provider is an individual.
Provider Business Practice Location Address State Name: MD
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider Business Practice Location Address Postal Code: 211575845
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 4108768637
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 4108575273
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 6/30/2005
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Last Update Date: 10/9/2019
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Authorized Official Last Name: DIAMOND
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Authorized Official First Name: ERIC
The first name of the authorized official.
Authorized Official Middle Name: L
The middle name of the authorized official.
Authorized Official Title or Position: OWNER
The title or position of the authorized official.
Authorized Official Telephone Number: 4108768637
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 213E00000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1: 00898
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 1: MD
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1: Y
Other Provider Identifier 1: 455055
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 1: 01
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Other Provider Identifier Issuer 1: AETNA HMO
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Other Provider Identifier 2: 174130
The last name of the provider. If the provider is an individual, this is the legal name.
Other Provider Identifier Type Code 2: 01
The first name of the provider, if the provider is an individual.
Other Provider Identifier Issuer 2: COVENTRY
The middle name of the provider, if the provider is an individual.
Other Provider Identifier 3: 492776
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Other Provider Identifier Type Code 3: 01
Other last name by which the provider being identified is or has been known.
Other Provider Identifier Issuer 3: NCPPO
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier 4: E351
Other Provider Identifier Type Code 4: 01
Other Provider Identifier State 4: DC
Other Provider Identifier Issuer 4: CAREFIRST BS
Other Provider Identifier 5: 279608200
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 5: 05
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 5: MD
Other Provider Identifier 6: 90209000000
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 6: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier Issuer 6: PREFERRED HEALTH
Other Provider Identifier 7: 30463
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 7: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier Issuer 7: MAMSI
Other Provider Identifier 8: 1243564001
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 8: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier Issuer 8: CIGNA
Other Provider Identifier 9: 116079
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 9: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier Issuer 9: KAISER
Other Provider Identifier 10: 2700091
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 10: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier Issuer 10: UNITED HEALTHCARE
Other Provider Identifier 11: 4121973
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 11: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier Issuer 11: AETNA PPO
Other Provider Identifier 12: KY26
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 12: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 12: MD
Other Provider Identifier Issuer 12: CAREFIRST BS
Is Organization Subpart: N
Authorized Official Name Prefix Text: DR.
Authorized Official Credential Text: DPM
Healthcare Provider Taxonomy Group 1: 193400000X SINGLE SPECIALTY GROUP