Potomac Integrative Health PLLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

POTOMAC INTEGRATIVE HEALTH PLLC

Practice address

207 S Princess Street
Suite 11
Shepherdstown, WV 25443

Phone

(304) 579-4746

Fax

(304) 579-4673

NPI assigned

Apr 4, 2013

Last updated

Oct 4, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

David Didden, M.D.NPI 1659375905

Title

Director

Phone

(304) 579-4746

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David Didden, M.D.

  • Family Medicine Physician
  • Shepherdstown, WV
  • NPI 1659375905
  Authorized official Same address or phone

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

{
    "created_epoch": "1365033600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380844800000",
    "number": "1235472523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1411",
            "city": "SHEPHERDSTOWN",
            "state": "WV",
            "postal_code": "254431411",
            "telephone_number": "304-579-4746",
            "fax_number": "304-579-4673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 S PRINCESS STREET",
            "address_2": "SUITE 11",
            "city": "SHEPHERDSTOWN",
            "state": "WV",
            "postal_code": "25443",
            "telephone_number": "304-579-4746",
            "fax_number": "304-579-4673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTOMAC INTEGRATIVE HEALTH PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-04",
        "last_updated": "2013-10-04",
        "status": "A",
        "authorized_official_last_name": "DIDDEN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "304-579-4746",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Yoon Park
• J. Peterson, PH.D., L.L.C.
• Polonchak Educational Associates
• Cathy Polonchak, LICSW
• Potomac Crossroads Counseling, LLC
• Potomac Integrative Health PLLC
• Pratima Chandler DDS PLLC
• Professional Sportscare & Rehab of West Virginia, LLC
• Professional Sportscare & Rehab of West Virginia, LLC (Pivot Physical Therapy)
• Providence Counseling Ministries, Inc (New Horizons Counseling Services)

• Family Medicine Physician in Shepherdstown, WV
• Providers in Shepherdstown, WV by specialty
• Family Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2013; 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.