NPI Code Detail JSON Logo

1104199421 NPI number — KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC

NPI Number: 1104199421
Health Care Provider/Practitioner: KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC

Information about “1104199421” NPI (KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC) exists in 1104199421 in HTML format HTML  |  1104199421 in plain Text format TXT  |  1104199421 in PDF (Portable Document Format) PDF  |  1104199421 in an XML format XML  formats.

NPI Number : 1104199421 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1104199421",
    "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": "8008 WESTPARK DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MC LEAN",
    "PracticeLocationAddressStateName": "VA",
    "PracticeLocationAddressPostalCode": "22102-3109",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "703-490-8400",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/16/2012",
    "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": "291U00000X",
        "TaxonomyName": "Clinical Medical Laboratory",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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