Hyattsville Rehab Center, LLC

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

Legal business name

HYATTSVILLE REHAB CENTER, LLC

Practice address

7411 Riggs Rd Ste 219
Adelphi, MD 20783-4246

Phone

(703) 214-1000

NPI assigned

Apr 29, 2019

Organization subpart

No

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

Authorized official

Name

Su Min Ko, MDNPI 1336375450

Title

Owner

Phone

(703) 214-1000

Specialties & licenses 2

Addresses

Locations

Practitioners 1

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

• Su Min Ko, M.D.

  • Interventional Pain Medicine Physician
  • Fairfax, VA
  • NPI 1336375450
  NPD Authorized official

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

{
    "created_epoch": "1556496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1556668800000",
    "number": "1639733348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7411 RIGGS RD STE 219",
            "city": "ADELPHI",
            "state": "MD",
            "postal_code": "207834246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7411 RIGGS RD STE 219",
            "city": "ADELPHI",
            "state": "MD",
            "postal_code": "207834246",
            "telephone_number": "703-214-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HYATTSVILLE REHAB CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-29",
        "last_updated": "2019-05-01",
        "status": "A",
        "authorized_official_last_name": "KO",
        "authorized_official_first_name": "SU MIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "703-214-1000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Stephen Hughes, LPCP
• Tiffany Hughes, ED.S.
• Human Development Associates, Inc.
• Emily Hunter, ED.S., NCSP
• Fadea Husain, LMSW
• Joy C Ikechukwu
• Irene Healthcare Solutions, Inc.
• Jackson Wellness Group
• Zainab Jackson, NCC, LCPC
• Sule Jaja

• Pain Clinic/Center in Adelphi, MD
• Providers in Adelphi, MD by specialty
• Pain Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2019; 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.