NPI Code Detail JSON Logo

1205420247 NPI number — KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC

NPI Number: 1205420247
Health Care Provider/Practitioner: KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC

Information about “1205420247” NPI (KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC) exists in 1205420247 in HTML format HTML  |  1205420247 in plain Text format TXT  |  1205420247 in PDF (Portable Document Format) PDF  |  1205420247 in an XML format XML  formats.

NPI Number : 1205420247 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1205420247",
    "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": "5400 HILLMEADE RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BOWIE",
    "PracticeLocationAddressStateName": "MD",
    "PracticeLocationAddressPostalCode": "20720-4777",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "301-867-1330",
    "PracticeLocationAddressFaxNumber": "301-867-1332",
    "EnumerationDate": "02/20/2021",
    "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
  }
}
                
            

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