Rfom Nurse Practitioner Clinic, LLC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

R161889 Issued in MD

Legal business name

RFOM NURSE PRACTITIONER CLINIC, LLC

Doing business as

Affordable Healthcare Nurse Practitioner Clinic

Practice address

8238 Georgia Ave
Silver Spring, MD 20910-4516

Phone

(240) 447-3204

Fax

(301) 587-3204

NPI assigned

Sep 26, 2012

Organization subpart

No

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

Authorized official

Name

Stella K Jefferies, CRNPNPI 1568779478

Title

Ceo

Phone

(240) 447-3204

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Affordable Healthcare Nurse Practitioner Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in DC

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.

• Stella Kiah Jefferies, CRNP

  • Adult Health Nurse Practitioner
  • Silver Spring, MD
  • NPI 1568779478

  DC

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1348617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348617600000",
    "number": "1669723961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9656 BRASSIE WAY",
            "city": "MONTGOMERY VILLAGE",
            "state": "MD",
            "postal_code": "208861910",
            "telephone_number": "240-447-3204",
            "fax_number": "301-587-3204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8238 GEORGIA AVE",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209104516",
            "telephone_number": "240-447-3204",
            "fax_number": "301-587-3204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RFOM NURSE PRACTITIONER CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-26",
        "last_updated": "2012-09-26",
        "status": "A",
        "authorized_official_last_name": "JEFFERIES",
        "authorized_official_first_name": "STELLA",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "240-447-3204",
        "authorized_official_credential": "CRNP"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R161889",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "050213800",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Affordable Healthcare Nurse Practitioner Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stacy Reyes
• Cynthia Reynolds-Temple, OD
• Jonathan Reynolds
• Nima Rezaiyan, D.D.S
• Ali Rezazadeh Tehrani, M.D.
• Rhapsody Therapy LLC
• Jonathan Jong-Hwa Rhee, M.D.
• Marjoriann Rhule, AGNP, MSN, BSN
• Riar & Altschuler,MD, P.a.
• Abdullah Riar, M.D.

• Adult Health Nurse Practitioner in Silver Spring, MD
• Providers in Silver Spring, MD by specialty
• Adult Health Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2012; 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.