Active NPI
John Michael Kitchen, PT
- Physical Therapist
- Germantown, MD
National Provider Identifier
1023190758
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 21497
- Practice address
- 20528 Boland Farm Rd
Suite 111
Germantown, MD 20876-4021 - Phone
- (301) 528-8096
- Fax
- (301) 528-8083
- NPI assigned
- Oct 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 21497 | MD | Primary |
Addresses
Primary practice location
20528 Boland Farm Rd
Suite 111
Germantown, MD 20876-4021
Mailing address
20528 Boland Farm Rd
Suite 111
Germantown, MD 20876-4021
Phone (301) 528-8096
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 7654166 | Other | AETNA | |
| 64382802 | Other | CARE FIRST | |
| 0001 | Other | DC | BCBS DC |
| 47610168 | Other | MD | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21497 | MD | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1235520000000",
"number": "1023190758",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20528 BOLAND FARM RD",
"address_2": "SUITE 111",
"city": "GERMANTOWN",
"state": "MD",
"postal_code": "208764021",
"telephone_number": "301-528-8096",
"fax_number": "301-528-8083"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20528 BOLAND FARM RD",
"address_2": "SUITE 111",
"city": "GERMANTOWN",
"state": "MD",
"postal_code": "208764021",
"telephone_number": "301-528-8096",
"fax_number": "301-528-8083"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KITCHEN",
"first_name": "JOHN",
"middle_name": "MICHAEL",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-20",
"last_updated": "2009-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "21497",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7654166",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CARE FIRST",
"identifier": "64382802",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS DC",
"identifier": "0001",
"state": "DC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "47610168",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Germantown, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.