Individual provider Active NPI

Johny Joseph Edappully, M.D.

  • Family Medicine Physician
  • Olney, MD
National Provider Identifier
1053489336
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
D0037830 Issued in MD
Practice address
3416 Olandwood CT
207
Olney, MD 20832-1372
Phone
(301) 774-8355
Fax
(301) 774-1231
NPI assigned
Dec 2, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X D0037830 MD Primary

Addresses

Primary practice location

3416 Olandwood CT
207
Olney, MD 20832-1372

Mailing address

3416 Olandwood CT
207
Olney, MD 20832-1372
Phone (301) 774-8355

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080811000411 DC Practitioner - Family Practice 8628142569 Reassigns benefits to 1 organization
I20170120001353 MD Practitioner - Family Practice 8628142569 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3416 Olandwood CT
Suite 207
Olney, MD 20832-1373
Phone (301) 774-8355

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0037830MDMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Family Medical Center PA Family Medicine CurrentSince Dec 24, 1993 Accepting new patients
U N I Medical Care Inc CurrentSince Nov 20, 2016 Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients
U.N.I. Medical Care, Inc PastSince Nov 20, 2016 Accepting new patients

Locations

12272 Clarksville Pike
#A
Clarksville, MD 21029
Phone (443) 656-0306

6030 Daybreak Cir
Ste A150179
Clarksville, MD 21029

3416 Olandwood Ct
Ste 207
Olney, MD 20832
Phone (301) 774-8355

826 Washington Rd
Ste 110A
Westminster, MD 21157
Phone (410) 751-7480

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1165017600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053489336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3416 OLANDWOOD CT",
            "address_2": "207",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208321372",
            "telephone_number": "301-774-8355",
            "fax_number": "301-774-1231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3416 OLANDWOOD CT",
            "address_2": "207",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208321372",
            "telephone_number": "301-774-8355",
            "fax_number": "301-774-1231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDAPPULLY",
        "first_name": "JOHNY",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0037830",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olney, MD

Sources for this page

Verify at the official NPI Registry.