Active NPI
Jennifer Lucille Haas, DPT
- Physical Therapist
- Silver Spring, MD
National Provider Identifier
1083454458
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 27480
- Practice address
- 3120 Gracefield Rd
Silver Spring, MD 20904-5810 - Phone
- (301) 572-8372
- NPI assigned
- May 31, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 27480 | MD | Primary |
Addresses
Primary practice location
3120 Gracefield Rd
Silver Spring, MD 20904-5810
Mailing address
6445 Rockledge CT
Elkridge, MD 21075-5449
Phone (410) 507-3278
Other names 1
- Jennifer Lucille Kovalick
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27480 | MD | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1717113600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1717113600000",
"number": "1083454458",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6445 ROCKLEDGE CT",
"city": "ELKRIDGE",
"state": "MD",
"postal_code": "210755449",
"telephone_number": "410-507-3278"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3120 GRACEFIELD RD",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209045810",
"telephone_number": "301-572-8372"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAAS",
"first_name": "JENNIFER",
"middle_name": "LUCILLE",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-05-31",
"last_updated": "2024-05-31",
"certification_date": "2024-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "27480",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "KOVALICK",
"middle_name": "LUCILLE",
"code": "1",
"type": "Former Name"
}
]
}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 May 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.