NPIMap

Organization Active NPI

Deer Park Chiropractic P.C.

  • Chiropractor
  • Gaithersburg, MD
National Provider Identifier
1114050515
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1795 Issued in MD
Legal business name
DEER PARK CHIROPRACTIC P.C.
Practice address
604 S Frederick Ave
Suite 105
Gaithersburg, MD 20877-1275
Phone
(301) 990-4184
Fax
(301) 990-4187
NPI assigned
Mar 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Ehsan Khademi, D.C.
Title
President
Phone
(301) 990-4184

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 1795 MD Primary

Addresses

Primary practice location

604 S Frederick Ave
Suite 105
Gaithersburg, MD 20877-1275

Mailing address

604 S Frederick Ave
Suite 105
Gaithersburg, MD 20877-1275
Phone (301) 990-4184

National Provider Directory

National Provider Directory

Locations

604 S Frederick Ave
Ste 105
Gaithersburg, MD 20877
Phone (301) 990-4184

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114050515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 S FREDERICK AVE",
            "address_2": "SUITE 105",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208771275",
            "telephone_number": "301-990-4184",
            "fax_number": "301-990-4187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 S FREDERICK AVE",
            "address_2": "SUITE 105",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208771275",
            "telephone_number": "301-990-4184",
            "fax_number": "301-990-4187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEER PARK CHIROPRACTIC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KHADEMI",
        "authorized_official_first_name": "EHSAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-990-4184",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "1795",
            "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 Aug 22, 2020; 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.