Jerry L. Radas, P.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

SO1592 Issued in MD

Legal business name

JERRY L. RADAS, P.C.

Doing business as

Fulton Family Chiropractic

Practice address

7625 Maple Lawn Blvd
Suite 160
Fulton, MD 20759-2598

Phone

(301) 490-8550

Fax

(301) 490-8581

NPI assigned

Aug 5, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jerry Lee Radas, D.C.NPI 1396837753

Title

President

Phone

(301) 490-8550

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Fulton Family Chiropractic Doing business as

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jerry Lee Radas, DC

  • Chiropractor
  • Fulton, MD
  • NPI 1396837753
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295913600000",
    "number": "1538350855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7625 MAPLE LAWN BLVD",
            "address_2": "SUITE 160",
            "city": "FULTON",
            "state": "MD",
            "postal_code": "207592598",
            "telephone_number": "301-490-8550",
            "fax_number": "301-490-8581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7625 MAPLE LAWN BLVD",
            "address_2": "SUITE 160",
            "city": "FULTON",
            "state": "MD",
            "postal_code": "207592598",
            "telephone_number": "301-490-8550",
            "fax_number": "301-490-8581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERRY L. RADAS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-05",
        "last_updated": "2011-01-25",
        "status": "A",
        "authorized_official_last_name": "RADAS",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-490-8550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "SO1592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "W3530001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS OF MD",
            "identifier": "M123JL",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fulton Family Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Nirja Asit Inamdar, DO
• Thomas Grafton Issermoyer, PTA
• Anne E Itodo
• Ryan Haekwon Jang, DPT
• Majbritt S Jensen, LCSW-C
• John C Baar, Jr, DDS, LLC
• Johns Hopkins Community Physicians (JHCP Social Worker- 8115 Maple Lawn Blvd. Ste 140)
• Johns Hopkins Community Physicians (JHCP - 8115 Maple Lawn Blvd SUITE 140)
• Johns Hopkins Community Physicians (JHCP - 8115 Maple Lawn Blvd)
• Johns Hopkins Community Physicians, Inc (JHCP - 8115 Maple Lawn Blvd Ste 140 - Prov Type - 27)

• Chiropractor in Fulton, MD
• Providers in Fulton, MD by specialty
• Chiropractor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.