EASTERN SHORE PRIMARY CARE – NPI #1831463298
Family Medicine

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

EASTERN SHORE PRIMARY CARE is a provider located in CHESTER, MD. NPPES has assigned the NPI number 1831463298 to EASTERN SHORE PRIMARY CARE on March 02, 2012. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “EASTERN SHORE PRIMARY CARE” is a dba name, the actual legal business name for this organization is LUMINIS HEALTH MEDICAL GROUP, LLC. The primary taxonomy selected by this provider is 207Q00000X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine.

The NPI profile was previously updated about 5 years ago on May 24, 2021. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for EASTERN SHORE PRIMARY CARE below.

NPI Profile for
LUMINIS HEALTH MEDICAL GROUP, LLC

NPI Number
1831463298
Enumeration Date

(more than 14 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
LUMINIS HEALTH MEDICAL GROUP, LLC
Doing Business As (dba): EASTERN SHORE PRIMARY CARE
Primary location
1630 MAIN ST
CHESTER, MD 21619-2791
Phone: (410) 643-4524 Fax: (410) 643-4523
Mailing address
PO BOX 12622
BELFAST, ME 04915-4017
Phone: (443) 481-6576 Fax: (443) 481-6515
Organization Subpart
No
Authorized Official
PETER ODENWALD
VICE PRESIDENT
Phone: (443) 481-6415
Updated
Certification Date
May 24, 2021

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for EASTERN SHORE PRIMARY CARE

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
OTHERAETNA HMOMD830799
OTHERAETNA PPOMD8580111
OTHERCAREFIRSTAB1100
MEDICAIDMD4071751-37
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207Q00000X
- Family Medicine (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.