Organization Active NPI

Greater Washington Dermatology PA

  • Specialist
  • Rockville, MD
National Provider Identifier
1174736516
Registry record updated Dec 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
D0043966 Issued in MD
Legal business name
GREATER WASHINGTON DERMATOLOGY PA
Practice address
2401 Research Blvd Ste 260
Rockville, MD 20850-3261
Phone
(301) 990-6565
Fax
(301) 990-8525
NPI assigned
May 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2009

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

Authorized official

Name
Dr. Jay M Barnett, M.D.
Title
Owner President
Phone
(301) 990-6565

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X D0043966 MD Primary

Addresses

Primary practice location

2401 Research Blvd Ste 260
Rockville, MD 20850-3261

Mailing address

2401 Research Blvd Ste 260
Rockville, MD 20850-3261
Phone (301) 990-6565

Other identifiers 1

IdentifierTypeStateIssuer
171451100MedicaidMD

National Provider Directory

National Provider Directory

Locations

104 E Pennsylvania Ave
Towson, MD 21286
Phone (410) 823-3422

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260403200000",
    "number": "1174736516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 RESEARCH BLVD STE 260",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503261",
            "telephone_number": "301-990-6565",
            "fax_number": "301-990-8525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2401 RESEARCH BLVD STE 260",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503261",
            "telephone_number": "301-990-6565",
            "fax_number": "301-990-8525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER WASHINGTON DERMATOLOGY PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-08",
        "last_updated": "2009-12-10",
        "status": "A",
        "authorized_official_last_name": "BARNETT",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "301-990-6565",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MD",
            "license": "D0043966",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171451100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2009; 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.