Potomac Healthcare Alliance

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

License

10554640 Issued in MD

Legal business name

POTOMAC HEALTHCARE ALLIANCE

Practice address

198 Thomas Johnson Dr Ste 5
Frederick, MD 21702-4449

Phone

(301) 624-5390

NPI assigned

Oct 17, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Patrick Eskew, CEO

Title

Ceo

Phone

(301) 642-5390

Specialties & licenses 1

Addresses

Other identifiers 3

Tax ID family

Potomac Healthcare Alliance LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Potomac Healthcare Alliance LLC

  • Pain Clinic/Center
  • Frederick, MD
  • NPI 1245582832
  NPD tax ID

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

{
    "created_epoch": "1350432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1350432000000",
    "number": "1164775979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "198 THOMAS JOHNSON DR STE 5",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024449",
            "telephone_number": "301-624-5390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "198 THOMAS JOHNSON DR STE 5",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024449",
            "telephone_number": "301-624-5390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTOMAC HEALTHCARE ALLIANCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-17",
        "last_updated": "2012-10-17",
        "status": "A",
        "authorized_official_last_name": "ESKEW",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "301-642-5390",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "CEO"
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "MD",
            "license": "10554640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1215171863",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1720248198",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1477595916",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Poteat, OT
• Kathleen Potesta
• Mende Ellen Potkay, LCSW-C
• Potomac Case Management Services
• Potomac Case Management Services, Inc.
• Potomac Healthcare Alliance LLC
• Potomac Institute of Pain Management and Palliative Care Services
• Potomac Labs LLC
• Potomac Medical Equipment
• Potomac Medical LLC

• Pain Clinic/Center in Frederick, MD
• Providers in Frederick, MD by specialty
• Pain Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.