Potomac Spine, LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

POTOMAC SPINE, LLC

Practice address

1050 Key Pkwy Ste 103
Frederick, MD 21702-4496

Phone

(240) 629-3982

NPI assigned

Dec 13, 2016

Organization subpart

No

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

Authorized official

Name

Kal Kahloon

Title

Ceo

Phone

(240) 629-3990

Specialties & licenses 4

Addresses

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Advanced Pain Management, LLC

  • Orthopaedic Surgery of the Spine Physician
  • Frederick, MD
  • NPI 1194230383

  Member Of

  NPD member

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ojedapo A. Ojeyemi, M.D

  • Orthopaedic Surgery of the Spine Physician
  • Frederick, MD
  • NPI 1437317005
  NPD (past)

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

{
    "created_epoch": "1481587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1521244800000",
    "number": "1083158885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 KEY PKWY",
            "address_2": "SUITE 202",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024053",
            "telephone_number": "240-629-3990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 KEY PKWY STE 103",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024496",
            "telephone_number": "240-629-3982"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12070 Old Line Ctr Ste 210",
            "address_purpose": "LOCATION",
            "city": "Waldorf",
            "state": "MD",
            "postal_code": "206022567",
            "country_code": "US",
            "telephone_number": "240-629-3939",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1050 Key Pkwy Ste 104",
            "address_purpose": "LOCATION",
            "city": "Frederick",
            "state": "MD",
            "postal_code": "217024496",
            "country_code": "US",
            "telephone_number": "240-629-3939",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12070 Old Line Ctr Ste 205",
            "address_purpose": "LOCATION",
            "city": "Waldorf",
            "state": "MD",
            "postal_code": "206022567",
            "country_code": "US",
            "telephone_number": "240-629-3939",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "POTOMAC SPINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-13",
        "last_updated": "2018-03-17",
        "status": "A",
        "authorized_official_last_name": "KAHLOON",
        "authorized_official_first_name": "KAL",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "240-629-3990"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XS0117X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Orthopaedic Surgery of the Spine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Potomac Healthcare Alliance LLC
• Potomac Institute of Pain Management and Palliative Care Services
• Potomac Labs LLC
• Potomac Medical Equipment
• Potomac Medical LLC
• Potomac Toxicology Laboratories Inc
• Potomac Wound Care Specialists
• Deborah S. Pow, LCSW-C
• Aubrie Powell, MOT
• Cearrah Powell

• Physical Medicine & Rehabilitation Physician in Frederick, MD
• Providers in Frederick, MD by specialty
• Physical Medicine & Rehabilitation Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.