The Potomac School

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

0126000115 Issued in VA

Legal business name

THE POTOMAC SCHOOL

Practice address

1301 Potomac School Rd
MC Lean, VA 22101-2350

Phone

(703) 489-7632

NPI assigned

Apr 22, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Terrence Cummings, L.A.T.C.

Title

Head Athletic Trainer

Phone

(703) 489-7632

Specialties & licenses 1

Addresses

Other identifiers 1

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

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1429660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429660800000",
    "number": "1164819660",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 POTOMAC SCHOOL RD",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221012350",
            "telephone_number": "703-489-7632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 POTOMAC SCHOOL RD",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221012350",
            "telephone_number": "703-489-7632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE POTOMAC SCHOOL",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-22",
        "last_updated": "2015-04-22",
        "status": "A",
        "authorized_official_last_name": "CUMMINGS",
        "authorized_official_first_name": "TERRENCE",
        "authorized_official_title_or_position": "HEAD ATHLETIC TRAINER",
        "authorized_official_telephone_number": "703-489-7632",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "L.A.T.C."
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "VA",
            "license": "0126000115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "2255A2300X",
            "identifier": "0126000115",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in MC Lean, VA
• Providers in MC Lean, VA by specialty
• Athletic Trainer in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.