LOWER SHORE CLINIC, INC. (NPI# 1154320646) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154320646 |
| Entity Type | Organization |
| Organization Name | LOWER SHORE CLINIC, INC. |
| Practice Address |
505 E Main St Salisbury MD 21804 |
| Mailing Address |
716 N Division St Salisbury MD 21801-4156 |
| Practice Telephone | 4103413420 |
| Practice Fax Number | 4103413397 |
| Mailing Telephone | 4103413420 |
| Mailing Fax Number | 4103413397 |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2019-09-25 |
| Authorized Official Name | KRISTINE GARTLITZ (CLINIC DIRECTOR) |
| Authorized Official Telephone | 4103413420 |
| Authorized Official Credential | LCSW-C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM0801X |
Clinic/Center Specialization: Mental Health (Including Community Mental Health Center) |
MD | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | BLUE CROSS BLUE SHIELD MD | LS92 | 01 |
| MD | 298470900 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417424466 | Lower Shore Clinic, Inc. | Community/Behavioral Health | 828 Airpax Rd # 600b, Cambridge, MD 21613-6401 | 2018-10-29 |
| 1275858417 | Lower Shore Clinic, Inc. | Community/Behavioral Health | 431 E Main St, Salisbury, MD 21804 | 2010-03-31 |
| 1770716458 | Lower Shore Clinic, Inc. | Community/Behavioral Health | 120 Banjo Ln, Centreville, MD 21617-1002 | 2009-08-28 |
| Street Address |
505 E MAIN ST |
| City | SALISBURY |
| State | MD |
| Zip Code | 21804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336704584 | Labake G Ogunnupe | Nurse Practitioner | 505 E Main St, Salisbury, MD 21804-5020 | 2019-05-02 |
| 1538683479 | Kristin Kelly | Nurse Practitioner | 505 E Main St, Salisbury, MD 21804-5020 | 2017-08-02 |
| 1528599677 | Lower Shore Pharmacy | Pharmacy | 505 E Main St, Salisbury, MD 21804-5020 | 2017-03-21 |
| 1629515812 | Kristine Hickman | Nurse Practitioner | 505 E Main St, Salisbury, MD 21804-5020 | 2017-01-25 |
| 1316329378 | Karly Peterson | Physician Assistant | 505 E Main St, Salisbury, MD 21804-5020 | 2015-06-25 |
| 1699180307 | Andrew Karten | Social Worker | 505 E Main St, Salisbury, MD 21804-5020 | 2014-06-23 |
| 1164773248 | Jeannette Kathleen Buchanan | Social Worker | 505 E Main St, Salisbury, MD 21804-5020 | 2012-09-28 |
| 1356608137 | Kristine R Garlitz | Social Worker | 505 E Main St, Salisbury, MD 21804-5020 | 2012-04-18 |
| 1780950725 | Lower Shore Clinic, Inc | Clinic/Center | 505 E Main St, Salisbury, MD 21804-5020 | 2012-03-23 |
| 1578831087 | Susan Lee Gray | Social Worker | 505 E Main St, Salisbury, MD 21804-5020 | 2011-12-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578125969 | Lifes Energy Wellness Center Inc. | Community/Behavioral Health | 2324 West Zion Road Suite, Suite 112, Salisbury, MD 21804 | 2019-07-05 |
| 1578125340 | Lifes Energy Wellness Center Inc. | Counselor | 2324 West Zion Road Suite 112, Suite 112, Salisbury, MD 21804 | 2019-07-02 |
| 1093377855 | Lifes Energy Wellness Center Inc. | Clinic/Center | 2324 West Zion Road Suite #112, Salisbury, MD 21804 | 2019-07-02 |
| 1356904874 | Carly Showell Finkbeiner | Behavioral Analyst | 30507 Foxchase Dr, Salisbury, MD 21804 | 2019-04-19 |
| 1750844940 | Clifton Waters | Driver | 206 Davis St, Salisbury, MD 21804 | 2019-04-13 |
| 1487125415 | Rebecca J. Raygor | Social Worker | Wicomico High School, 201 Long Ave., Salisbury, MD 21804 | 2018-12-17 |
| 1639662745 | Peninsula Physical Therapy, LLC | Physical Therapist | 720 E College Ave Ste 11, Salisbury, MD 21804 | 2018-06-13 |
| 1376079533 | Kerry Choplin | Behavior Technician | 8032 Snow Hill Rd., Salisbury, MD 21804 | 2017-05-10 |
| 1558892992 | Three Lower Counties Community Services, Inc. | Clinic/Center | 1647 Woodbrooke Drive, Salisbury, MD 21804 | 2017-03-27 |
| 1508304759 | Driven Physiotherapy, LLC | Clinic/Center | 1029 Zircon Ct., Salisbury, MD 21804 | 2017-02-08 |
| Find all providers in zip 21804 | ||||
| Taxonomy Code | 261QM0801X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Mental Health (Including Community Mental Health Center) |
| Definition to come... |
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| 1275027088 | Fearless Growth Therapeutic Services, LLC | Clinic/Center | 225 N Division St Rm 207, Salisbury, MD 21801-4302 | 2018-06-15 |
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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.