NPIMap

Organization Active NPI

Potomac Physical Therapy LLC

  • Physical Therapist
  • Waldorf, MD
National Provider Identifier
1700184611
Registry record updated Mar 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
POTOMAC PHYSICAL THERAPY LLC
Practice address
3010 Crain Hwy
Suite 100
Waldorf, MD 20601-2801
Phone
(301) 567-8856
NPI assigned
Mar 2, 2011
Last updated
Mar 2, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 2, 2011

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

Authorized official

Name
Kevin Renee Colvin, DPTNPI 1609107598
Title
Owner
Phone
(301) 567-8856

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

3010 Crain Hwy
Suite 100
Waldorf, MD 20601-2801

Mailing address

3010 Crain Hwy
Suite 100
Waldorf, MD 20601-2801
Phone (301) 567-8856

National Provider Directory

National Provider Directory

Locations

3010 Crain Hwy
Ste 100
Waldorf, MD 20601
Phone (240) 988-0872

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1299024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299024000000",
    "number": "1700184611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3010 CRAIN HWY",
            "address_2": "SUITE 100",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206012801",
            "telephone_number": "301-567-8856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 CRAIN HWY",
            "address_2": "SUITE 100",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206012801",
            "telephone_number": "301-567-8856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTOMAC PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-02",
        "last_updated": "2011-03-02",
        "status": "A",
        "authorized_official_last_name": "COLVIN",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-567-8856",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2011; 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.