Individual provider Active NPI

Kristoffer Querubin, PT

  • Physical Therapist
  • Oxon Hill, MD
National Provider Identifier
1457548976
Registry record updated Sep 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
22325 Issued in MD
Practice address
6196 Oxon Hill Rd
Oxon Hill, MD 20745-3100
Phone
(301) 851-8051
Fax
(301) 564-0283
NPI assigned
Sep 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2007

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 22325 MD Primary

Addresses

Primary practice location

6196 Oxon Hill Rd
Oxon Hill, MD 20745-3100

Mailing address

6410 Rockledge Dr
NRH Regional Rehab - Suite 600
Bethesda, MD 20817-1809
Phone (301) 581-8051

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
22325MDMDSchool Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1190937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190937600000",
    "number": "1457548976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6410 ROCKLEDGE DR",
            "address_2": "NRH REGIONAL REHAB - SUITE 600",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208171809",
            "telephone_number": "301-581-8051",
            "fax_number": "301-564-0284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6196 OXON HILL RD",
            "city": "OXON HILL",
            "state": "MD",
            "postal_code": "207453100",
            "telephone_number": "301-851-8051",
            "fax_number": "301-564-0283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUERUBIN",
        "first_name": "KRISTOFFER",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-28",
        "last_updated": "2007-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "22325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxon Hill, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2007; 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.