NPIMap

Organization Active NPI

Shady Grove Podiatry LLC

  • Durable Medical Equipment & Medical Supplies
  • Gaithersburg, MD
National Provider Identifier
1093859720
Registry record updated Jul 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
SHADY GROVE PODIATRY LLC
Practice address
16220 S Frederick Ave
Suite 200
Gaithersburg, MD 20877-4039
Phone
(301) 948-2995
Fax
(301) 948-6056
NPI assigned
Feb 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2009

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

Authorized official

Name
Katherine Diggins
Title
Office Manager
Phone
(301) 948-2995

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X MD Primary

Addresses

Primary practice location

16220 S Frederick Ave
Suite 200
Gaithersburg, MD 20877-4039

Mailing address

16220 S Frederick Ave
Suite 200
Gaithersburg, MD 20877-4039
Phone (301) 948-2995

National Provider Directory

National Provider Directory

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": "1171584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246406400000",
    "number": "1093859720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16220 S FREDERICK AVE",
            "address_2": "SUITE 200",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208774039",
            "telephone_number": "301-948-2995",
            "fax_number": "301-948-6056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16220 S FREDERICK AVE",
            "address_2": "SUITE 200",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208774039",
            "telephone_number": "301-948-2995",
            "fax_number": "301-948-6056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADY GROVE PODIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-16",
        "last_updated": "2009-07-01",
        "status": "A",
        "authorized_official_last_name": "DIGGINS",
        "authorized_official_first_name": "KATHERINE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "301-948-2995"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaithersburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2009; 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.