NPIMap

Individual provider Active NPI

Liesl Kaye Nottingham, M.D.

  • Specialist
  • Silver Spring, MD
National Provider Identifier
1154581486
Registry record updated Jul 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
D0063680 Issued in MD
Practice address
2415 Musgrove Rd
Suite 203
Silver Spring, MD 20904-5200
Phone
(301) 989-2300
Fax
(301) 236-5357
NPI assigned
Jun 10, 2008
Last updated
Jul 6, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X D0063680 MD Primary
Otolaryngology Physician 207Y00000X D0063680 MD

Addresses

Primary practice location

2415 Musgrove Rd
Suite 203
Silver Spring, MD 20904-5200

Mailing address

2415 Musgrove Rd
Suite 203
Silver Spring, MD 20904-5200
Phone (301) 989-2300

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081121000079 DC Practitioner - Otolaryngology 1951461888 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Perelman School of Med at the University of Pennsylvania, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians

Practice addresses (Care Compare)

2415 Musgrove Rd
Suite 203
Silver Spring, MD 20904-5228
Phone (301) 989-2300

9470 Annapolis Rd
Suite 309
Lanham, MD 20706-3022
Phone (202) 832-1800

950 N Glebe Rd
Suite 700
Arlington, VA 22203-4173

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0063680MDMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC Otolaryngology CurrentSince Jun 23, 2016 Accepting new patients
Privia Medical Group, LLC CurrentSince Jun 23, 2016 Accepting new patients
Nova Physician Wellness Center PLLC Past Accepting new patients
Frederick Health Hospital Inc Past Accepting new patients

Locations

9470 Annapolis Rd
Ste 309
Lanham, MD 20706
Phone (202) 832-1800

2415 Musgrove Rd
Ste 203
Silver Spring, MD 20904
Phone (301) 989-2300

950 N Glebe Rd
Ste 4000
Arlington, VA 22203
Phone (301) 593-9011

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/8042/brand/1/csg/1/fhir/r4
  • Direct secure messaging: liesl.nottingham.1@8042.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1213056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278374400000",
    "number": "1154581486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2415 MUSGROVE RD",
            "address_2": "SUITE 203",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209045200",
            "telephone_number": "301-989-2300",
            "fax_number": "301-236-5357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2415 MUSGROVE RD",
            "address_2": "SUITE 203",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209045200",
            "telephone_number": "301-989-2300",
            "fax_number": "301-236-5357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOTTINGHAM",
        "first_name": "LIESL",
        "middle_name": "KAYE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-10",
        "last_updated": "2010-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MD",
            "license": "D0063680",
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MD",
            "license": "D0063680",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

Verify at the official NPI Registry.