Individual provider Active NPI

Tamara Evette Johnson

  • Physical Medicine & Rehabilitation Physician
  • Oxon Hill, MD
National Provider Identifier
1174700413
Registry record updated Mar 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
20141 Issued in MD
Practice address
6196 Oxon Hill Rd
Suite 430
Oxon Hill, MD 20745-3100
Phone
(301) 567-1678
Fax
(301) 567-2728
NPI assigned
Jan 29, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 20141 MD Primary
Physical Medicine & Rehabilitation Physician 208100000X 2305202035 VA

Addresses

Primary practice location

6196 Oxon Hill Rd
Suite 430
Oxon Hill, MD 20745-3100

Mailing address

PO Box 79586
Baltimore, MD 21279-3100
Phone (301) 567-1678

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130731000281 DC Practitioner - Physical Therapist in Private Practice 1052552247 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Sports Pro Physical Therapy South LLCGroup PAC ID 4880919638, 4 clinicians

Practice addresses (Care Compare)

930 E Swan Creek Rd
Fort Washington, MD 20744-5250
Phone (301) 805-5006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20141MDMDPharmacist
2305202035VAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Sports Pro Physical Therapy South LLC CurrentSince Jan 15, 2015 Accepting new patients
Hamid R Quraishi MD & Shannaz H Quraishi MD PA Physical Medicine & Rehabilitation Past Accepting new patients

Locations

930 E Swan Creek Rd
Ft Washington, MD 20744
Phone (301) 292-9400

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1201564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364342400000",
    "number": "1174700413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 79586",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212793100",
            "telephone_number": "301-567-1678",
            "fax_number": "301-567-2728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6196 OXON HILL RD",
            "address_2": "SUITE 430",
            "city": "OXON HILL",
            "state": "MD",
            "postal_code": "207453100",
            "telephone_number": "301-567-1678",
            "fax_number": "301-567-2728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TAMARA",
        "middle_name": "EVETTE",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-01-29",
        "last_updated": "2013-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MD",
            "license": "20141",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "VA",
            "license": "2305202035",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxon Hill, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.