Spiros T Theodore DC PC

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

License

S02045 Issued in MD

Legal business name

SPIROS T THEODORE DC PC

Practice address

12105 Darnestown Rd Ste L-8-9
Gaithersburg, MD 20878-2217

Phone

(301) 869-0006

Fax

(301) 869-0201

NPI assigned

May 23, 2007

Organization subpart

No

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

Authorized official

Name

Spiro T Theodore, DC

Title

President

Phone

(301) 869-0006

Specialties & licenses 2

Addresses

Other identifiers 4

Other names 1

• Potomac Valley Chiropractic Doing business as

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Locations

Practitioners 3

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

• Spiros T Theodore, D.C. PC

  • Chiropractor
  • Gaithersburg, MD
  • NPI 1457358855

  DC

  Medicare reassignment NPD
• Marvin Diaz-Lemus

  • Rehabilitation Chiropractor
  • Gaithersburg, MD
  • NPI 1447116363
  NPD (past)
• Joann Theodore, RD

  • Registered Dietitian
  • Gaithersburg, MD
  • NPI 1376693549
  NPD (past)

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1770163200000",
    "number": "1740490242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12105 DARNESTOWN RD STE L8-9",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208782217",
            "telephone_number": "301-869-0006",
            "fax_number": "301-869-0201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12105 DARNESTOWN RD STE L-8-9",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208782217",
            "telephone_number": "301-869-0006",
            "fax_number": "301-869-0201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPIROS T THEODORE DC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2026-02-04",
        "certification_date": "2026-02-04",
        "status": "A",
        "authorized_official_last_name": "THEODORE",
        "authorized_official_first_name": "SPIRO",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-869-0006",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "02045",
            "primary": false
        },
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "MD",
            "license": "S02045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS",
            "identifier": "KCS6PO",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0106381",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010638100",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS",
            "identifier": "S8600001",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Potomac Valley Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Rehabilitation Chiropractor in Gaithersburg, MD
• Providers in Gaithersburg, MD by specialty
• Rehabilitation Chiropractor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2026; 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.