Potomac Family Medicine

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

NOT APPLICABLE Issued in MD

Legal business name

POTOMAC FAMILY MEDICINE

Practice address

13424 Pennsylvania Ave
Suite 101
Hagerstown, MD 21742

Phone

(301) 791-7900

Fax

(301) 791-3686

NPI assigned

Jun 15, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Deborah R Lee

Title

Practice Manager

Phone

(301) 791-7900

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1118793600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210118400000",
    "number": "1255336483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 PENNSYLVANIA AVE",
            "address_2": "SUITE 101",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "21742",
            "telephone_number": "301-791-7900",
            "fax_number": "301-791-3686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13424 PENNSYLVANIA AVE",
            "address_2": "SUITE 101",
            "city": "HAGERSTOWN",
            "state": "MD",
            "postal_code": "21742",
            "telephone_number": "301-791-7900",
            "fax_number": "301-791-3686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTOMAC FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-15",
        "last_updated": "2008-05-07",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "301-791-7900",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "NOT APPLICABLE",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS/BLUESHIELD",
            "identifier": "S328",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "599121800",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL BLACK LUNG PROGRA",
            "identifier": "202589",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard Joseph Porac, D.D.S.
• Positive Pathways and Wellness Center
• Potomac Case Management Services, Inc. (Potomac Community Services)
• Potomac Case Management Services, Inc. (Potomac Community Services)
• Potomac Dental Centre P.a. (Potomac Dental Centre)
• Potomac Surgical Specialists, LLC
• Tanner Powell
• Tylea Powell
• Powerback Rehabilitation LLC
• Michelle Poye-Seal, LCSW-C

• Family Medicine Physician in Hagerstown, MD
• Providers in Hagerstown, MD by specialty
• Family Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2008; 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.