NPIMap

Organization Active NPI

Koman Orthopedics and Sports Medicine, LLC

  • Sports Medicine (Orthopaedic Surgery) Physician
  • Reisterstown, MD
National Provider Identifier
1750703864
Registry record updated Jun 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X
License
D0055676 Issued in MD
Legal business name
KOMAN ORTHOPEDICS AND SPORTS MEDICINE, LLC
Practice address
116 Westminster Pike
Suite 100
Reisterstown, MD 21136-1027
Phone
(410) 833-9300
NPI assigned
Jan 8, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2015

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
Ceo/Orthopedic Surgeon
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
Sports Medicine (Orthopaedic Surgery) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207XX0005X D0055676 MD Primary

Addresses

Primary practice location

116 Westminster Pike
Suite 100
Reisterstown, MD 21136-1027

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
H812A363OtherMDMEDICARE PTAN

National Provider Directory

National Provider Directory

Locations

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

Practitioners & affiliated clinicians

Practitioners 2

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": "1389139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433203200000",
    "number": "1750703864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 WESTMINSTER PIKE STE 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 ORTHOPEDICS AND SPORTS MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-08",
        "last_updated": "2015-06-02",
        "status": "A",
        "authorized_official_last_name": "KOMAN",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "CEO/ORTHOPEDIC SURGEON",
        "authorized_official_telephone_number": "410-833-9300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "MD",
            "license": "D0055676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "H812A363",
            "state": "MD"
        }
    ],
    "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 Jun 2, 2015; 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.