KENNEDY KRIEGER ASSOCIATES, INC - MENTAL HEALTH GROUP PROVIDER (NPI# 1215327259) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215327259 |
| Entity Type | Organization |
| Organization Name | KENNEDY KRIEGER ASSOCIATES, INC - MENTAL HEALTH GROUP PROVIDER |
| Practice Address |
707 N. Broadway Baltimore MD 21205 |
| Mailing Address |
P.o. Box 744865 Atlanta GA 30374 |
| Practice Telephone | 4439239200 |
| Practice Fax Number | 4439239405 |
| Mailing Telephone | 4439231872 |
| Mailing Fax Number | 4439231875 |
| Enumeration Date | 2015-01-29 |
| Last Update Date | 2020-09-16 |
| Authorized Official Name | MR. MIKE J NEUMAN (VICE PRESIDENT FINANCE) |
| Authorized Official Telephone | 4439231810 |
| Is Organization Subpart | Y |
| Parent Organization Name | KENNEDY KRIEGER INSTITUTE |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities | ||
| Y | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | BLUE CROSS FEDERAL | F158 | 01 |
| MD | BLUE CROSS MARYLAND | K631 | 01 |
| MD | 168641100 | 05 |
| Street Address |
707 N. BROADWAY |
| City | BALTIMORE |
| State | MD |
| Zip Code | 21205 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043261043 | Sakkubai Naidu | Psychiatry & Neurology | 707 N. Broadway, Baltimore, MD 21205 | 2006-05-14 |
| 1073138715 | Christine Pho | Student in an Organized Health Care Education/Training Program | 707 N. Broadway, Baltimore, MD 21205 | 2020-06-09 |
| 1679979686 | Aishah Aifadhalah | Speech-Language Pathologist | 707 N. Broadway, Baltimore, MD 21205 | 2014-11-18 |
| 1033478623 | Mindy Lee Cavendish | Speech-Language Pathologist | 707 N. Broadway, Baltimore, MD 21205 | 2012-05-16 |
| 1952625675 | Bradley R Grant | Psychiatry & Neurology | 707 N. Broadway, Baltimore, MD 21205 | 2010-03-24 |
| 1053572958 | Kennedy Krieger Associates, Inc. | Psychologist | 707 N. Broadway, Baltimore, MD 21205 | 2008-06-23 |
| 1164638391 | Kennedy Krieger Children's Hospital, Inc. | Durable Medical Equipment & Medical Supplies | 707 N. Broadway, Baltimore, MD 21205 | 2007-05-15 |
| 1881800027 | Kennedy Krieger Children's Hospital, Inc. | Chronic Disease Hospital | 707 N. Broadway, Baltimore, MD 21205 | 2007-05-15 |
| 1629199708 | Carrie Roylance Zetlmeisi | Speech-Language Pathologist | 707 N. Broadway, Baltimore, MD 21205 | 2007-04-03 |
| 1982750543 | Suzanne Marie Rybczynski | Pediatrics | 707 N. Broadway, Baltimore, MD 21205 | 2007-01-26 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467019034 | Meghna Rajaprakash | Student in an Organized Health Care Education/Training Program | 716 N Broadway, Rm 431, Baltimore, MD 21205 | 2019-05-20 |
| 1871158592 | Rachel Samantha Bronheim | Student in an Organized Health Care Education/Training Program | 610 N Caroline St, 5th Floor, Baltimore, MD 21205 | 2019-05-08 |
| 1700342250 | Ruth Leeanna Williams | Social Worker | 504 N. Caroline Street, Baltimore, MD 21205 | 2019-02-20 |
| 1174017032 | Anna Kathryn Chassevent | Genetic Counselor, MS | 801 N. Broadway, Baltimore, MD 21205 | 2018-06-14 |
| 1588115653 | Redeem Healthcare and Medical System Inc | Case Management | 917 North Caroline Street, Baltimore, MD 21205 | 2016-10-24 |
| 1013334929 | Crystal Diane Salcido | Psychiatry & Neurology | 855 N Wolfe St Ste 300, Baltimore, MD 21205 | 2014-03-28 |
| 1487088464 | Laura Mitchell | Nurse Practitioner | 707 N. Broadway Ave, Baltimore, MD 21205 | 2013-08-27 |
| 1477992410 | Ferbet Take Care Health Maryland, P.C. | Nurse Practitioner | 900 N. Washington Street, Baltimore, MD 21205 | 2013-06-24 |
| 1225370570 | Amena Smith Fine | Pediatrics | Kennedy Krieger Institute, 707 N Broadway, Baltimore, MD 21205 | 2013-03-25 |
| 1356695993 | Kalpana Prasad | Student in an Organized Health Care Education/Training Program | 800 North Wolfe St., John G. Rangos, Sr. Building, Room 248, 2nd Floor, Baltimore, MD 21205 | 2012-11-05 |
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| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| 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. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285248211 | Lauren Mendelsohn-levin, Md LLC | Pediatrics | 6905 Granite Ridge Ct, Baltimore, MD 21209-3856 | 2020-09-08 |
| 1790321172 | Lifebridge Metropolitan Physician Group II, LLC | Pediatrics | 1 E University Pkwy Unit 109, Baltimore, MD 21218-2432 | 2019-11-21 |
| 1528534062 | Baltimore City Health Department | Pediatrics | 1301 Mcculloh St, Baltimore, MD 21217-3044 | 2018-10-23 |
| 1730664012 | Privia Care Center LLC | Pediatrics | 301 Saint Paul St Ste 409, Baltimore, MD 21202-2102 | 2018-10-02 |
| 1386147932 | Das Pediatrics | Pediatrics | 821 N Eutaw St Ste 305, Baltimore, MD 21201-6303 | 2018-03-09 |
| 1184142762 | Marieta S Caragay,m.d. | Pediatrics | 3455 Wilkens Ave Ste 102, Baltimore, MD 21229-5204 | 2017-09-05 |
| 1114455425 | Umar Qadri | Pediatrics | 4940 Eastern Ave # 021044, Baltimore, MD 21224-2735 | 2017-05-31 |
| 1487185765 | Jennifer Dibiagio | Pediatrics | 6565 N Charles St Ste 309, Baltimore, MD 21204-5804 | 2017-03-27 |
| 1538525456 | Catherine Deangelis | Pediatrics | 200 Tuscany Rd, Baltimore, MD 21210-3010 | 2016-01-07 |
| 1275913881 | Agape Health Systems | Pediatrics | 2300 Garrison Blvd Ste 130, Baltimore, MD 21216-2316 | 2015-06-09 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.