Individual provider Active NPI

Dong H Ko, DPT

  • Physical Therapist
  • Fulton, MD
National Provider Identifier
1457458143
Registry record updated Oct 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
20478 Issued in MD
Practice address
7625 Maple Lawn Blvd
Suite 140
Fulton, MD 20759-2565
Phone
(301) 497-3070
Fax
(301) 497-3071
NPI assigned
Sep 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 20478 MD Primary

Addresses

Primary practice location

7625 Maple Lawn Blvd
Suite 140
Fulton, MD 20759-2565

Mailing address

7625 Maple Lawn Blvd
Suite 140
Fulton, MD 20759-2565
Phone (301) 497-3070

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070709000147 MD Practitioner - Physical Therapist in Private Practice 9436056728 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
May accept Medicare assignment
Group practices
Synergy Therapy, LLCGroup PAC ID 0446350490, 4 clinicians

Practice addresses (Care Compare)

7625 Maple Lawn Blvd
Suite 140
Fulton, MD 20759-2565
Phone (301) 497-3070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
20478MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Synergy Therapy, LLC Physical Therapist CurrentSince Jan 4, 2007 Accepting new patients

Locations

7625 Maple Lawn Blvd
Ste 140
Fulton, MD 20759
Phone (301) 497-3070

9123 Gaither Rd
Gaithersburg, MD 20877
Phone (301) 497-3070

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1288310400000",
    "number": "1457458143",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7625 MAPLE LAWN BLVD",
            "address_2": "SUITE 140",
            "city": "FULTON",
            "state": "MD",
            "postal_code": "207592565",
            "telephone_number": "301-497-3070",
            "fax_number": "301-497-3071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7625 MAPLE LAWN BLVD",
            "address_2": "SUITE 140",
            "city": "FULTON",
            "state": "MD",
            "postal_code": "207592565",
            "telephone_number": "301-497-3070",
            "fax_number": "301-497-3071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KO",
        "first_name": "DONG",
        "middle_name": "H",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-17",
        "last_updated": "2010-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "20478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fulton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.