NPIMap

Organization Active NPI

Potomac Audiology LLC

  • Audiologist
  • Rockville, MD
National Provider Identifier
1003010489
Registry record updated Sep 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
875 Issued in MD
Legal business name
POTOMAC AUDIOLOGY LLC
Practice address
11300 Rockville Pike
Suite 105
Rockville, MD 20852-3003
Phone
(240) 477-1010
Fax
(240) 477-1012
NPI assigned
Jun 12, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Vinze B Terlep
Title
Director of Operations
Phone
(240) 477-1010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
AudiologistGroup: 193400000X SINGLE SPECIALTY GROUP 231H00000X 875 MD Primary

Addresses

Primary practice location

11300 Rockville Pike
Suite 105
Rockville, MD 20852-3003

Mailing address

11300 Rockville Pike
Suite 105
Rockville, MD 20852-3003
Phone (240) 477-1010

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20080930000810 DC Part B Supplier - Clinic/Group Practice 4385716505 Receives reassigned benefits from 6 practitioners
Practice locations: Rockville, MD
O20241227001807 DC Part B Supplier - Clinic/Group Practice 4385716505 Receives reassigned benefits from 3 practitioners
Practice locations: Rockville, MD

National Provider Directory

National Provider Directory

Locations

11300 Rockville Pike
Ste 105
Rockville, MD 20852
Phone (240) 477-1010

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1181606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1631750400000",
    "number": "1003010489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11300 ROCKVILLE PIKE",
            "address_2": "SUITE 105",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208523003",
            "telephone_number": "240-477-1010",
            "fax_number": "240-477-1014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11300 ROCKVILLE PIKE",
            "address_2": "SUITE 105",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208523003",
            "telephone_number": "240-477-1010",
            "fax_number": "240-477-1012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTOMAC AUDIOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-12",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A",
        "authorized_official_last_name": "TERLEP",
        "authorized_official_first_name": "VINZE",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "240-477-1010"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Audiologist",
            "state": "MD",
            "license": "875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.