NPIMap

Organization Active NPI

Montgomery Sports Medicine Center

  • Sports Medicine (Family Medicine) Physician
  • Bethesda, MD
National Provider Identifier
1043898018
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
Legal business name
MONTGOMERY SPORTS MEDICINE CENTER
Practice address
6931 Arlington Rd Ste 550
Bethesda, MD 20814-7217
Phone
(301) 754-0505
Fax
(301) 754-0509
NPI assigned
Mar 31, 2021
Organization subpart
Yes
Parent organization
ERAN KESSOUS MD PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

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

Authorized official

Name
Eran Kessous, MDNPI 1821033358
Title
Director
Phone
(301) 754-0505

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QS0010X Primary

Addresses

Primary practice location

6931 Arlington Rd Ste 550
Bethesda, MD 20814-7217

Mailing address

11120 New Hampshire Ave Ste 411
Silver Spring, MD 20904-2620
Phone (301) 754-0505

National Provider Directory

National Provider Directory
Tax ID family
Montgomery Sports Medicine Center6 organizations share this tax ID, including this one
Part of
Montgomery Sports Medicine Center

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

Locations

6931 Arlington Rd
Ste 550
Bethesda, MD 20814
Phone (301) 754-0505

11120 New Hampshire Ave
Ste 411
Silver Spring, MD 20904
Phone (301) 754-0505

Practitioners & affiliated clinicians

Practitioners 1

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": "1617148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617148800000",
    "number": "1043898018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11120 NEW HAMPSHIRE AVE STE 411",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209042620",
            "telephone_number": "301-754-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6931 ARLINGTON RD STE 550",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208147217",
            "telephone_number": "301-754-0505",
            "fax_number": "301-754-0509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONTGOMERY SPORTS MEDICINE CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ERAN KESSOUS MD PC",
        "enumeration_date": "2021-03-31",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A",
        "authorized_official_last_name": "KESSOUS",
        "authorized_official_first_name": "ERAN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "301-754-0505",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.