AMBUSH PEDIATRICS AND FAMILY MEDICAL CLINIC – NPI #1457956948
Family Medicine

A family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs.

AMBUSH PEDIATRICS AND FAMILY MEDICAL CLINIC is a provider located in HALETHORPE, MD. NPPES has assigned the NPI number 1457956948 to AMBUSH PEDIATRICS AND FAMILY MEDICAL CLINIC on December 02, 2020. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207QA0000X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine, specializing in Adolescent Medicine

The NPI profile was last updated on Apr 29, 2026. 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 AMBUSH PEDIATRICS AND FAMILY MEDICAL CLINIC below.

NPI Profile for
AMBUSH PEDIATRICS AND FAMILY MEDICAL CLINIC

NPI Number
1457956948
Enumeration Date

(more than 5 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
AMBUSH PEDIATRICS AND FAMILY MEDICAL CLINIC
Primary location
4367 HOLLINS FERRY RD STE 1C
HALETHORPE, MD 21227-3400
Phone: (410) 609-6677 Fax: (410) 609-6672
1 Other location(s):
5252 Hollister St Ste 203C
Houston, TX 77040-6214
Phone: (346) 678-4442
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
JACQUELINE AMBUSH
OWNER/OPERATOR
Phone: (410) 707-5947
Updated
Certification Date
Apr 29, 2026

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 AMBUSH PEDIATRICS AND FAMILY MEDICAL CLINIC

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
medicaidMD080454100
medicaidMD999223500
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
207QA0000X
- Family Medicine / Adolescent Medicine (Primary)
261QH0100X
- Clinic/Center / Health Service

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.

Endpoint

Health Information Exchange (HEI)

HEI is the mobilization of health care information electronically across organizations within a region, community or hospital system. Endpoints provide a simple and secure way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the internet such as primary care physicians, specialists, hospitals, labs, etc.

Endpoint
[email protected]
Endpoint type
Other URL
Endpoint Description
EMAIL FOR PRACTICE
Content Type
CSV
Affiliation
N
Endpoint Location
4367 HOLLINS FERRY RD STE 1C,
BALTIMORE, MD 77025-1669