Active NPI
Raymond Martin Harrell, M.D.
- Interventional Pain Medicine Physician
- Woodbridge, VA
National Provider Identifier
1134325632
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Interventional Pain Medicine Physician
- License
- 0101257583
- Practice address
- 14605 Potomac Branch Dr
Suite 100
Woodbridge, VA 22191-3336 - Phone
- (703) 738-4371
- Fax
- (703) 642-1876
- NPI assigned
- Jun 22, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Interventional Pain Medicine Physician | 208VP0014X | D0080491 | MD | |
| Interventional Pain Medicine Physician | 208VP0014X | 0101257583 | VA | Primary |
Addresses
Primary practice location
14605 Potomac Branch Dr
Suite 100
Woodbridge, VA 22191-3336
Mailing address
14605 Potomac Branch Dr
Suite 100
Woodbridge, VA 22191-3336
Phone (703) 738-4371
Other names 1
- Dr. Martin Harrell
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D0080491 | MD | MD | Interventional Pain Medicine Physician |
| 0101257583 | VA | MD | Interventional Pain Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physical Medicine Associates LTD | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Clinical Laboratory Director (Non-physician)
- Columbia, MD
- NPI 1750840666
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458777600000",
"number": "1134325632",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14605 POTOMAC BRANCH DR",
"address_2": "SUITE 100",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "221913336",
"telephone_number": "703-738-4371",
"fax_number": "703-642-1876"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14605 POTOMAC BRANCH DR",
"address_2": "SUITE 100",
"city": "WOODBRIDGE",
"state": "VA",
"postal_code": "221913336",
"telephone_number": "703-738-4371",
"fax_number": "703-642-1876"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARRELL",
"first_name": "RAYMOND",
"middle_name": "MARTIN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-22",
"last_updated": "2016-03-24",
"status": "A"
},
"taxonomies": [
{
"code": "208VP0014X",
"taxonomy_group": "",
"desc": "Pain Medicine, Interventional Pain Medicine",
"state": "MD",
"license": "D0080491",
"primary": false
},
{
"code": "208VP0014X",
"taxonomy_group": "",
"desc": "Pain Medicine, Interventional Pain Medicine",
"state": "VA",
"license": "0101257583",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARTIN",
"last_name": "HARRELL",
"prefix": "DR.",
"credential": "M.D.",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Woodbridge, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 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.