Individual provider Active NPI

Damon Anthony, D.C.

  • Chiropractor
  • Rockville, MD
National Provider Identifier
1487050506
Registry record updated Nov 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
S03799 Issued in MD
Practice address
6101 Executive Blvd
Suite 280
Rockville, MD 20852-3907
Phone
(301) 231-0050
Fax
(301) 231-6057
NPI assigned
Nov 17, 2014
Last updated
Nov 17, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X S03799 MD Primary
Chiropractor 111N00000X CH030122 DC

Addresses

Primary practice location

6101 Executive Blvd
Suite 280
Rockville, MD 20852-3907

Mailing address

6101 Executive Blvd
Suite 280
Rockville, MD 20852-3907
Phone (301) 231-0050

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191007002441 CA Practitioner - Chiropractic 1759692098 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
34408CAMDClinical Psychologist
CH030122DCMDChiropractor
S03799MDMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
First Health Medical Center of Fresno Inc Chiropractor CurrentSince Jul 27, 2019 Accepting new patients
Community Foundation Medical Group Past Accepting new patients

Locations

7161 N Howard St
Ste 100
Fresno, CA 93720
Phone (559) 227-2273

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1416182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416182400000",
    "number": "1487050506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6101 EXECUTIVE BLVD",
            "address_2": "SUITE 280",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208523907",
            "telephone_number": "301-231-0050",
            "fax_number": "301-231-6057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6101 EXECUTIVE BLVD",
            "address_2": "SUITE 280",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208523907",
            "telephone_number": "301-231-0050",
            "fax_number": "301-231-6057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTHONY",
        "first_name": "DAMON",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-17",
        "last_updated": "2014-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "S03799",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "DC",
            "license": "CH030122",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2014; 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.