NPIMap

Organization Active NPI

Progressive Spinal and Sports Rehabilitation, PC

  • Rehabilitation Chiropractor
  • Rockville, MD
National Provider Identifier
1598802423
Registry record updated Feb 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
02093 Issued in MD
Legal business name
PROGRESSIVE SPINAL AND SPORTS REHABILITATION, PC
Practice address
15200 Shady Grove Rd
Suite 211
Rockville, MD 20850-3218
Phone
(240) 477-8719
NPI assigned
Jan 31, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2010

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

Authorized official

Name
Dr. John H Park, D.C.NPI 1659418572
Title
Owner
Phone
(240) 477-8719

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NR0400X 02093 MD Primary

Addresses

Primary practice location

15200 Shady Grove Rd
Suite 211
Rockville, MD 20850-3218

Mailing address

15200 Shady Grove Rd
Suite 211
Rockville, MD 20850-3218
Phone (240) 477-8719

National Provider Directory

National Provider Directory

Locations

10076 Darnestown Rd
Ste 200
Rockville, MD 20850
Phone (301) 208-2225

15200 Shady Grove Rd
Ste 211
Rockville, MD 20850
Phone (240) 477-8719

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265068800000",
    "number": "1598802423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15200 SHADY GROVE RD",
            "address_2": "SUITE 211",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503218",
            "telephone_number": "240-477-8719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15200 SHADY GROVE RD",
            "address_2": "SUITE 211",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503218",
            "telephone_number": "240-477-8719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE SPINAL AND SPORTS REHABILITATION, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2010-02-02",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "240-477-8719",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "MD",
            "license": "02093",
            "primary": true
        }
    ],
    "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 Feb 2, 2010; 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.