NPIMap

Organization Active NPI

Avalon Health LLC

  • Chiropractor
  • Gaithersburg, MD
National Provider Identifier
1437484276
Registry record updated Dec 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
S01866 Issued in MD
Legal business name
AVALON HEALTH LLC
Practice address
811 Russell Ave Ste B
Gaithersburg, MD 20879-3524
Phone
(301) 987-0111
Fax
(240) 668-9463
NPI assigned
Oct 13, 2009
Last updated
Dec 16, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2019

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

Authorized official

Name
Mr. William S Oloughlin, DCNPI 1225127384
Title
Owner
Phone
(301) 987-0111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X S01866 MD Primary

Addresses

Primary practice location

811 Russell Ave Ste B
Gaithersburg, MD 20879-3524

Mailing address

811 Russell Ave Ste B
Gaithersburg, MD 20879-3524
Phone (301) 987-0111

Other identifiers 2

IdentifierTypeStateIssuer
030459000MedicaidMD
1225127384MedicaidMD

National Provider Directory

National Provider Directory

Locations

811 Russell Ave
Ste B
Gaithersburg, MD 20879
Phone (301) 740-9339

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1255392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576454400000",
    "number": "1437484276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 RUSSELL AVE STE B",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208793524",
            "telephone_number": "301-987-0111",
            "fax_number": "301-987-0114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 RUSSELL AVE STE B",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208793524",
            "telephone_number": "301-987-0111",
            "fax_number": "240-668-9463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AVALON HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-13",
        "last_updated": "2019-12-16",
        "certification_date": "2019-12-16",
        "status": "A",
        "authorized_official_last_name": "OLOUGHLIN",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-987-0111",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "S01866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "030459000",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1225127384",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gaithersburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2019; 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.