NPIMap

Organization Active NPI

Koman Orthopaedics and Sports Medicine, LLC

  • Physical Therapy Clinic/Center
  • Reisterstown, MD
National Provider Identifier
1679976815
Registry record updated Mar 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
D0055676 Issued in MD
Legal business name
KOMAN ORTHOPAEDICS AND SPORTS MEDICINE, LLC
Practice address
116 Westminster Pike
Suite 100
Reisterstown, MD 21136-1027
Phone
(410) 833-9300
NPI assigned
Oct 2, 2014
Reactivated
Mar 5, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2020

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

Authorized official

Name
Dr. Jon David Koman, MDNPI 1215925128
Title
Owner
Phone
(410) 833-9300

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
Physical Therapy Clinic/Center 261QP2000X D0055676 MD Primary

Addresses

Primary practice location

116 Westminster Pike
Suite 100
Reisterstown, MD 21136-1027

Mailing address

116 Westminster Pike
Suite 100
Reisterstown, MD 21136-1027
Phone (410) 833-9300

National Provider Directory

National Provider Directory
Tax ID family
Koman Orthopedics and Sports Medicine2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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": "1412208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583366400000",
    "number": "1679976815",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 WESTMINSTER PIKE",
            "address_2": "SUITE 100",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211361027",
            "telephone_number": "410-833-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 WESTMINSTER PIKE",
            "address_2": "SUITE 100",
            "city": "REISTERSTOWN",
            "state": "MD",
            "postal_code": "211361027",
            "telephone_number": "410-833-9300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOMAN ORTHOPAEDICS AND SPORTS MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-02",
        "last_updated": "2020-03-05",
        "certification_date": "2020-03-05",
        "deactivation_date": "2018-02-08",
        "reactivation_date": "2020-03-05",
        "status": "A",
        "authorized_official_last_name": "KOMAN",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-833-9300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MD",
            "license": "D0055676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reisterstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2020; 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.