Organization Active NPI

Internal Medicine of Chevy Chase, P.a.

  • Internal Medicine Physician
  • Chevy Chase, MD
National Provider Identifier
1720377013
Registry record updated Apr 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
M18811 Issued in MD
Legal business name
INTERNAL MEDICINE OF CHEVY CHASE, P.A.
Practice address
5530 Wisconsin Ave
Suite 1400
Chevy Chase, MD 20815-4404
Phone
(301) 656-9170
Fax
(301) 654-5893
NPI assigned
Apr 7, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2011

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

Authorized official

Name
Dr. George W Graves, MDNPI 1104919133
Title
President
Phone
(301) 656-9170

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X M18811 MD Primary

Addresses

Primary practice location

5530 Wisconsin Ave
Suite 1400
Chevy Chase, MD 20815-4404

Mailing address

5530 Wisconsin Ave
Suite 1400
Chevy Chase, MD 20815-4302
Phone (301) 656-9170

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111107000327 DC Part B Supplier - Clinic/Group Practice 5193998292 Receives reassigned benefits from 5 practitioners
Practice locations: Chevy Chase, MD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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": "1302134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302134400000",
    "number": "1720377013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5530 WISCONSIN AVE",
            "address_2": "SUITE 1400",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208154302",
            "telephone_number": "301-656-9170",
            "fax_number": "301-654-5893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5530 WISCONSIN AVE",
            "address_2": "SUITE 1400",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208154404",
            "telephone_number": "301-656-9170",
            "fax_number": "301-654-5893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE OF CHEVY CHASE, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-07",
        "last_updated": "2011-04-07",
        "status": "A",
        "authorized_official_last_name": "GRAVES",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-656-9170",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "M18811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chevy Chase, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2011; 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.