Active NPI
John Martin Chamberlain, PH.D.
- Clinical Psychologist
- Silver Spring, MD
National Provider Identifier
1114137098
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 3623
- Practice address
- 8720 Georgia Ave
Suite 1000
Silver Spring, MD 20910-3638 - Phone
- (301) 495-0266
- NPI assigned
- May 22, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY1000161 | DC | |
| Clinical Psychologist | 103TC0700X | 3623 | MD | Primary |
Addresses
Primary practice location
8720 Georgia Ave
Suite 1000
Silver Spring, MD 20910-3638
Mailing address
8720 Georgia Ave
Suite 1000
Silver Spring, MD 20910-3638
Phone (301) 495-0266
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jun 15, 2022 through Jun 15, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY1000161 | DC | MD | Clinical Psychologist |
| 3623 | MD | MD | Clinical Psychologist |
| 03623 | MD | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179792000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1287014400000",
"number": "1114137098",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8720 GEORGIA AVE",
"address_2": "SUITE 1000",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209103638",
"telephone_number": "301-495-0266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8720 GEORGIA AVE",
"address_2": "SUITE 1000",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209103638",
"telephone_number": "301-495-0266"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHAMBERLAIN",
"first_name": "JOHN",
"middle_name": "MARTIN",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-22",
"last_updated": "2010-10-14",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "DC",
"license": "PSY1000161",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MD",
"license": "3623",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Oct 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.