NPIMap

Organization Active NPI

Kinetic Medical Group

  • Family Nurse Practitioner
  • Potomac, MD
National Provider Identifier
1285228585
Registry record updated Feb 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
KINETIC MEDICAL GROUP
Practice address
9544 Newbridge Dr
Potomac, MD 20854-4480
Phone
(703) 485-5689
NPI assigned
Feb 26, 2021
Last updated
Feb 26, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2021

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

Authorized official

Name
Anna Norwood, CRNPNPI 1306335492
Title
President
Phone
(703) 485-5689

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

9544 Newbridge Dr
Potomac, MD 20854-4480

Mailing address

7110 Ayers Meadow LN
Springfield, VA 22150-4915
Phone (703) 485-5689

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, NC, DE3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20220721000588 MD Part B Supplier - Clinic/Group Practice 5294141909 Receives reassigned benefits from 13 practitioners
Practice locations: Frederick, MD; Easton, MD; Edgewater, MD
O20240326000233 NC Part B Supplier - Clinic/Group Practice 5294141909 Receives reassigned benefits from 7 practitioners
Practice locations: Huntersville, NC
O20240514000194 DE Part B Supplier - Clinic/Group Practice 5294141909 Receives reassigned benefits from 1 practitioner
Practice locations: Wilmington, DE

National Provider Directory

National Provider Directory

Locations

700 Foulk Rd
Wilmington, DE 19803
Phone (302) 328-1582

Practitioners & affiliated clinicians

Practitioners 33

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.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1614297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614297600000",
    "number": "1285228585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7110 AYERS MEADOW LN",
            "city": "SPRINGFIELD",
            "state": "VA",
            "postal_code": "221504915",
            "telephone_number": "703-485-5689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9544 NEWBRIDGE DR",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208544480",
            "telephone_number": "703-485-5689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KINETIC MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-26",
        "last_updated": "2021-02-26",
        "certification_date": "2021-02-26",
        "status": "A",
        "authorized_official_last_name": "NORWOOD",
        "authorized_official_first_name": "ANNA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "703-485-5689",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Potomac, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.