NPIMap

Organization Active NPI

Eran Kessous MD PC

  • Physical Therapy Clinic/Center
  • Silver Spring, MD
National Provider Identifier
1104282409
Registry record updated Jan 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
D0066523 Issued in MD
Legal business name
ERAN KESSOUS MD PC
Practice address
11120 New Hampshire Ave
411
Silver Spring, MD 20904-2633
Phone
(301) 754-0505
Fax
(301) 754-0509
NPI assigned
Jan 4, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2016

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

Authorized official

Name
Ms. Dona Maria Bowie
Title
Office Manager
Phone
(301) 754-0505

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X D0066523 MD Primary

Addresses

Primary practice location

11120 New Hampshire Ave
411
Silver Spring, MD 20904-2633

Mailing address

11120 New Hampshire Ave
411
Silver Spring, MD 20904-2633
Phone (301) 754-0505

Other identifiers 1

IdentifierTypeStateIssuer
182336OtherMDMEDICARE PTAN

Other names 1

  • MONTGOMERY SPORTS MEDICINE CENTER Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Montgomery Sports Medicine Center6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the 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": "1451865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451865600000",
    "number": "1104282409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11120 NEW HAMPSHIRE AVE",
            "address_2": "411",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209042633",
            "telephone_number": "301-754-0505",
            "fax_number": "301-754-0509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11120 NEW HAMPSHIRE AVE",
            "address_2": "411",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209042633",
            "telephone_number": "301-754-0505",
            "fax_number": "301-754-0509"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERAN KESSOUS MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-04",
        "last_updated": "2016-01-04",
        "status": "A",
        "authorized_official_last_name": "BOWIE",
        "authorized_official_first_name": "DONA",
        "authorized_official_middle_name": "MARIA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "301-754-0505",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MD",
            "license": "D0066523",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "182336",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MONTGOMERY SPORTS MEDICINE CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 4, 2016; 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.