Organization Active NPI

Human Performance LLC

  • Psychologist
  • Silver Spring, MD
National Provider Identifier
1053508671
Registry record updated Sep 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
1926 Issued in DC
Legal business name
HUMAN PERFORMANCE LLC
Practice address
2906 Aquarius Ave
Silver Spring, MD 20906-1813
Phone
(240) 277-4427
NPI assigned
Sep 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2007

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

Authorized official

Name
Dr. Donna Toby Kimmel, PHDNPI 1902812357
Title
President
Phone
(240) 277-4427

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X 1926 DC Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 862 DC
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 15251 MD

Addresses

Primary practice location

2906 Aquarius Ave
Silver Spring, MD 20906-1813

Mailing address

2906 Aquarius Ave
Silver Spring, MD 20906-1813
Phone (240) 277-4427

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050309000715 DC Part B Supplier - Clinic/Group Practice 5991759276 Receives reassigned benefits from 1 practitioner
Practice locations: Bethesda, MD; Washington, DC

National Provider Directory

National Provider Directory

Locations

4545 42nd St NW
Ste 212
Washington, DC 20016
Phone (202) 244-4855

4000 Albemarle St NW
Washington, DC 20016
Phone (202) 841-1498

5312 Connecticut Ave NW
Washington, DC 20015
Phone (240) 277-4427

6286 Montrose Rd
Rockville, MD 20852
Phone (240) 242-4133

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": "1190851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190851200000",
    "number": "1053508671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2906 AQUARIUS AVE",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209061813",
            "telephone_number": "240-277-4427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2906 AQUARIUS AVE",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209061813",
            "telephone_number": "240-277-4427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMAN PERFORMANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-27",
        "last_updated": "2007-09-27",
        "status": "A",
        "authorized_official_last_name": "KIMMEL",
        "authorized_official_first_name": "DONNA",
        "authorized_official_middle_name": "TOBY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "240-277-4427",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "DC",
            "license": "1926",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "DC",
            "license": "862",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "15251",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2007; 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.