Organization Active NPI

Potomac Internists, P.C.

  • Internal Medicine Physician
  • Washington, DC
National Provider Identifier
1124319116
Registry record updated May 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
POTOMAC INTERNISTS, P.C.
Practice address
5215 Loughboro Rd NW
Suite 440
Washington, DC 20016-2618
Phone
(202) 237-2910
Fax
(202) 237-2913
NPI assigned
Apr 25, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2021

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

Authorized official

Name
Dr. Kevin G Nealon, M.D.
Title
President
Phone
(202) 237-2910

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

5215 Loughboro Rd NW
Suite 440
Washington, DC 20016-2618

Mailing address

5215 Loughboro Rd NW
Suite 440
Washington, DC 20016-2618
Phone (202) 237-2910

Other identifiers 1

IdentifierTypeStateIssuer
1124319116OtherDCNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111118000211 DC Part B Supplier - Clinic/Group Practice 9032383518 Receives reassigned benefits from 5 practitioners
Practice locations: Washington, DC

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
09D2033097Potomac Internists, PC5215 Loughboro Rd, NW #440, Washington, DC 20016Certificate of waiverNov 21, 2027

National Provider Directory

National Provider Directory

Locations

5215 Loughboro Rd NW
Ste 440
Washington, DC 20016
Phone (202) 237-2911

Practitioners & affiliated clinicians

Practitioners 5

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": "1303689600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621296000000",
    "number": "1124319116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5215 LOUGHBORO RD NW",
            "address_2": "SUITE 440",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200162618",
            "telephone_number": "202-237-2910",
            "fax_number": "202-237-2913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5215 LOUGHBORO RD NW",
            "address_2": "SUITE 440",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200162618",
            "telephone_number": "202-237-2910",
            "fax_number": "202-237-2913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTOMAC INTERNISTS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-25",
        "last_updated": "2021-05-18",
        "certification_date": "2021-05-18",
        "status": "A",
        "authorized_official_last_name": "NEALON",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "202-237-2910",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1124319116",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.