DR. RICHARD LAROY DIETRICH (NPI# 1548336803) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548336803 |
| Entity Type | Individual |
| Full Name | DR. RICHARD LAROY DIETRICH |
| Credential | MD |
| Practice Address |
4920 Campbell Blvd Kaiser Permanente White Marsh Medical Center Nottingham MD 21236-5916 |
| Mailing Address |
2101 E Jefferson St Kaiser Permanente Medicaire Enrollment Rockville MD 20852-4908 |
| Practice Telephone | 4109337600 |
| Practice Fax Number | 4109337802 |
| Mailing Telephone | 3018162424 |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2011-11-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | 0101221514 | VA | Allopathic & Osteopathic Physicians |
| Y | 208000000X | Pediatrics | D0026218 | MD | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992859920 | Richard L Dietrich | Dentist | 2250 Nw Flanders St, Suite 109, Portland, OR 97210-3443 | 2007-01-23 |
| Street Address |
4920 CAMPBELL BLVD KAISER PERMANENTE WHITE MARSH MEDICAL CENTER |
| City | NOTTINGHAM |
| State | MD |
| Zip Code | 21236-5916 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811087174 | Lynn Mahan | Social Worker | 4920 Campbell Blvd, Nottingham, MD 21236-5916 | 2006-10-14 |
| 1104442425 | Martha M Georges | Pharmacist | 4920 Campbell Blvd, Nottingham, MD 21236-5916 | 2020-06-23 |
| 1891349502 | Bruce Dennis Conklin Jr. | Pharmacist | 4920 Campbell Blvd, Nottingham, MD 21236-5916 | 2019-07-31 |
| 1083125926 | Songe Baek | Pharmacist | 4920 Campbell Blvd, Nottingham, MD 21236-5916 | 2017-10-18 |
| 1528301272 | Neil Smith | Pharmacist | 4920 Campbell Blvd, Nottingham, MD 21236-5916 | 2013-04-01 |
| 1629211404 | Carrie Carlevaro | Social Worker | 4920 Campbell Blvd, Kaiser Permanente White Marsh Medical Center, Nottingham, MD 21236-5916 | 2009-04-09 |
| 1467692632 | Claire W Bolander | Obstetrics & Gynecology | 4920 Campbell Blvd, Kaiser Permanente Whitemarsh Medical Center, Nottingham, MD 21236-5916 | 2009-03-02 |
| 1902055973 | Natalie Simone Yzer - Newton | Psychiatry & Neurology | 4920 Campbell Blvd, Kaiser Permanente White Marsh Medical Center, Nottingham, MD 21236-5916 | 2008-09-15 |
| 1861650392 | Melissa Sinkiewicz | Physical Medicine & Rehabilitation | 4920 Campbell Blvd, Nottingham, MD 21236 | 2008-05-31 |
| 1700058104 | Amit Kumar | Social Worker | 4920 Campbell Blvd, Kaiser Permanente White Marsh Medical Center, Nottingham, MD 21236-5916 | 2008-03-26 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699381467 | Monique Gaston | Counselor | Well Life Counseling and Consulting, 9649 Belair Road, Ste. 104, Nottingham, MD 21236 | 2020-09-17 |
| 1215575519 | Bh Brightview Perry Hall Opco, LLC | Alzheimer Center (Dementia Center) | 9657 Belair Road, Nottingham, MD 21236 | 2019-12-17 |
| 1750929493 | Bh Brightview White Marsh Opco, LLC | Alzheimer Center (Dementia Center) | 8100 Rossville Blvd., Baltimore, MD 21236 | 2019-12-12 |
| 1083257646 | Matthew Peter Halstad | Behavioral Analyst | 8090 Sandpiper Circle, Nottingham, MD 21236 | 2019-10-25 |
| 1609331602 | Tunisia Buise | Social Worker | 4132 E. Joppa Road Ste. 110-#1248, Baltimore, MD 21236 | 2019-02-04 |
| 1730673047 | Golden Jemz Adult Medical Day | Clinic/Center | 5020 Cambell Blvd, Nottingham, MD 21236 | 2018-06-20 |
| 1487143400 | For Eyes Optical of Pa | Eyewear Supplier (Equipment, not the service) | 7984 Honeygo Blvd, Nottingham, MD 21236 | 2018-05-04 |
| 1619478922 | Weis Markets, Inc. | Pharmacy | 7927 Belair Rd Ste S, Nottingham, MD 21236 | 2018-02-22 |
| 1285133918 | Joan Rosa Keller | Behavior Technician | 3501 Taylor Ave., Baltimore, MD 21236 | 2018-02-08 |
| 1205341146 | Ebony Watkins | Nurse Practitioner | 8940 Kilkenny Circle, Nottingham, MD 21236 | 2017-12-13 |
| Find all providers in zip 21236 | ||||
| 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 |
|---|---|---|---|---|
| 1023127669 | Smita N Vazarkar | Pediatrics | 4924 Campbell Blvd Ste 200, Nottingham, MD 21236 | 2006-08-29 |
| 1477849149 | Kristen Shaw Deitchman | Pediatrics | 4924 Campbell Blvd, Suite 200, Nottingham, MD 21236-5908 | 2011-06-21 |
| 1487738902 | Anthony F Pinto IIi | Pediatrics | 4924 Campbell Blvd Ste 200, Nottingham, MD 21236-5914 | 2006-10-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417554031 | Mebe Maryland | Pediatrics | 11140 Rockville Pike # 565, Rockville, MD 20852-3106 | 2020-10-06 |
| 1982219739 | Jennifer Blansett | Pediatrics | 103 Centennial St Ste C, La Plata, MD 20646-5985 | 2020-09-09 |
| 1285248211 | Lauren Mendelsohn-levin, Md LLC | Pediatrics | 6905 Granite Ridge Ct, Baltimore, MD 21209-3856 | 2020-09-08 |
| 1538779509 | Blossoming Minds Pediatrics | Pediatrics | 11723 Trotter Crossing Ln, Clarksville, MD 21029-1445 | 2020-08-05 |
| 1033730668 | Cyd Patrice Campbell | Pediatrics | 102 Southwood Ave, Silver Spring, MD 20901-1917 | 2020-05-05 |
| 1487289757 | Deborah Lindsey | Pediatrics | 6008 Highland Dr, Chevy Chase, MD 20815-6612 | 2020-03-07 |
| 1245862135 | Kay Tomashek | Pediatrics | National Military Medical Center, 8901 Rockville Pike, Bethesda, MD 20889 | 2020-02-07 |
| 1427695824 | Naseem Khan | Pediatrics | 10851 Clarksville Pike, Columbia, MD 21044-1338 | 2019-12-04 |
| 1720625379 | Edge Pediatric LLC | Pediatrics | 7500 Hanover Pkwy Ste 203, Greenbelt, MD 20770-2009 | 2019-12-03 |
| 1790321172 | Lifebridge Metropolitan Physician Group II, LLC | Pediatrics | 1 E University Pkwy Unit 109, Baltimore, MD 21218-2432 | 2019-11-21 |
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| City | NOTTINGHAM |
| Zip Code | 21236 |
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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.