NPIMap

Organization Active NPI

First Clinic, LLC

  • Family Nurse Practitioner
  • Potomac, MD
National Provider Identifier
1427330463
Registry record updated Sep 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
R114087 Issued in MD
Legal business name
FIRST CLINIC, LLC
Practice address
9800 Falls Rd
Ste 3
Potomac, MD 20854-3999
Phone
(301) 765-9255
Fax
(301) 299-3838
NPI assigned
Sep 15, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2011

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

Authorized official

Name
Mrs. Kala Shahi, NPNPI 1427106277
Title
President
Phone
(301) 765-9255

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 R114087 MD Primary

Addresses

Primary practice location

9800 Falls Rd
Ste 3
Potomac, MD 20854-3999

Mailing address

9800 Falls Rd
Ste 3
Potomac, MD 20854-3999
Phone (301) 765-9255

Other identifiers 1

IdentifierTypeStateIssuer
R114087OtherMDMARYLAND STATE LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111104000356 DC Part B Supplier - Clinic/Group Practice 3072786110 Receives reassigned benefits from 1 practitioner
Practice locations: Potomac, MD

National Provider Directory

National Provider Directory

Locations

9800 Falls Rd
Ste 3
Potomac, MD 20854
Phone (301) 294-2755

Practitioners & affiliated clinicians

Practitioners 6

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": "1316044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316044800000",
    "number": "1427330463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9800 FALLS RD",
            "address_2": "STE 3",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208543999",
            "telephone_number": "301-765-9255",
            "fax_number": "301-299-3838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9800 FALLS RD",
            "address_2": "STE 3",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208543999",
            "telephone_number": "301-765-9255",
            "fax_number": "301-299-3838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-15",
        "last_updated": "2011-09-15",
        "status": "A",
        "authorized_official_last_name": "SHAHI",
        "authorized_official_first_name": "KALA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-765-9255",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R114087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARYLAND STATE LICENSE",
            "identifier": "R114087",
            "state": "MD"
        }
    ],
    "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 Sep 15, 2011; 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.