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Organization

KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC

Active
Parent organization
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
Other names
Kaiser Permanente
Organization subpart
Yes

Provider details

NPI number
Legal business name
KAISER FOUNDATION HEALTH PLAN OF THE MID ATLANTIC STATES, INC
Authorized official
COLLEEN E SWINTON (DIRECTOR,CREDENTIALING/PROVIDER ENR)
(301) 257-2797
Entity
Organization

Contact information

Practice address
KAISER PERMANENTE-SOUTH BALTIMORE, 1701 TWIN SPRINGS ROAD, HALETHORPE, MD 21227-3553
(410) 737-5000
(443) 263-7381
Mailing address
4000 GARDEN CITY DRIVE, 4TH FLOOR PPQA, HYATTSVILLE, MD 20785-2418
(301) 816-2424
(301) 816-7170

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
133N00000X
Nutritionist
163WP0200X
Pediatric Registered Nurse
207K00000X
Allergy & Immunology Physician
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
207RG0100X
Gastroenterology Physician
207RP1001X
Pulmonary Disease Physician
207V00000X
Obstetrics & Gynecology Physician
208200000X
Plastic Surgery Physician
2085R0202X
Diagnostic Radiology Physician
302R00000X
Health Maintenance Organization
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
K679
MEDICARE GROUP ID
MD
Enumeration date
12/05/2006
Last updated
07/24/2025
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