Potomac Cobbler, Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

License

1994 Issued in VA

Legal business name

POTOMAC COBBLER, INC

Practice address

14437 Jefferson Davis Highway
Woodbridge, VA 22191-2805

Phone

(703) 491-4222

Fax

(703) 491-1040

NPI assigned

Nov 26, 2008

Last updated

Nov 26, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. James Martin Brown Sr., BOARD CERTIFIED PEDO

Title

Sec/Treas. Potomac Cobber, Inc

Phone

(703) 491-4222

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• James Martin Brown, Sr., C.PED.

  • Prosthetic/Orthotic Supplier
  • Woodbridge, VA
  • NPI 1144410432
  NPD (past)

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

{
    "created_epoch": "1227657600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227657600000",
    "number": "1063667434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14437 JEFFERSON DAVIS HIGHWAY",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221912805",
            "telephone_number": "703-491-4222",
            "fax_number": "703-491-1040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14437 JEFFERSON DAVIS HIGHWAY",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221912805",
            "telephone_number": "703-491-4222",
            "fax_number": "703-491-1040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTOMAC COBBLER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-26",
        "last_updated": "2008-11-26",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "MARTIN",
        "authorized_official_title_or_position": "SEC/TREAS. POTOMAC COBBER, INC",
        "authorized_official_telephone_number": "703-491-4222",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "BOARD CERTIFIED PEDO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "VA",
            "license": "1994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Pope
• Jenna Popvich, LPC
• David L Postelnek, MD
• Potomac Audiology LLC
• Potomac Cardiovascular Consultants, LLC
• Potomac Dental Care PC
• Potomac Eye Care, PLLC
• Potomac Festival Urgent Care
• Potomac Health Pharmacy LLC (Potomac Health Pharmacy)
• Potomac Healthcare Solutions, LLC

• Prosthetic/Orthotic Supplier in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Prosthetic/Orthotic Supplier in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2008; 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.