NPI Code Detail JSON Logo

1073242517 NPI number — KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC

NPI Number: 1073242517
Health Care Provider/Practitioner: KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC

Information about “1073242517” NPI (KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC) exists in 1073242517 in HTML format HTML  |  1073242517 in plain Text format TXT  |  1073242517 in PDF (Portable Document Format) PDF  |  1073242517 in an XML format XML  formats.

NPI Number : 1073242517 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1073242517",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "Y",
    "ParentOrgLBN": "KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC",
    "ParentOrgTIN": null,
    "OrgName": "KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "4000 GARDEN CITY DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "HYATTSVILLE",
    "MailingAddressStateName": "MD",
    "MailingAddressPostalCode": "20785-2418",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "301-816-2424",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "5620 AGER ROAD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "HYATTSVILLE",
    "PracticeLocationAddressStateName": "MD",
    "PracticeLocationAddressPostalCode": "20782",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "240-906-6600",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "06/09/2022",
    "LastUpdateDate": "07/24/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "SWINTON",
    "AuthorizedOfficialFirstName": "COLLEEN",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "DIRECTOR, CREDENTIALING",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "301-257-2797",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "3336M0003X",
        "TaxonomyName": "Managed Care Organization Pharmacy",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.