NPIMap

Organization Active NPI

Potomac Pediatrics, P.C.

  • Non-Pharmacy Dispensing Site
  • Rockville, MD
National Provider Identifier
1124370150
Registry record updated Oct 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-Pharmacy Dispensing SiteTaxonomy code 332900000X
Legal business name
POTOMAC PEDIATRICS, P.C.
Practice address
15204 Omega Dr
Rockville, MD 20850-4601
Phone
(301) 279-6750
NPI assigned
Oct 15, 2012
Organization subpart
Yes
Parent organization
POTOMAC PEDIATRICS, P.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 15, 2012

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

Authorized official

Name
Caron Glassman, M.D.
Title
President
Phone
(301) 279-6750

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-Pharmacy Dispensing Site 332900000X Primary

Addresses

Primary practice location

15204 Omega Dr
Rockville, MD 20850-4601

Mailing address

6501 City West Pkwy
Eden Prairie, MN 55344-3248
Phone (952) 653-2525

Other names 1

  • Potomac Pediatrics, Suite 14 Other name

National Provider Directory

National Provider Directory
Tax ID family
Potomac Pediatrics PC16 organizations share this tax ID, including this one
Part of
Potomac Pediatrics PC

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1350259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350259200000",
    "number": "1124370150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6501 CITY WEST PKWY",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553443248",
            "telephone_number": "952-653-2525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15204 OMEGA DR",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208504601",
            "telephone_number": "301-279-6750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTOMAC PEDIATRICS, P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "POTOMAC PEDIATRICS, P.C.",
        "enumeration_date": "2012-10-15",
        "last_updated": "2012-10-15",
        "status": "A",
        "authorized_official_last_name": "GLASSMAN",
        "authorized_official_first_name": "CARON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-279-6750",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Potomac Pediatrics, Suite 14",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2012; 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.