Potomac Podiatry Associates LTD

Primary specialty

PodiatristTaxonomy code 213E00000X

License

0103000339 Issued in VA

Legal business name

POTOMAC PODIATRY ASSOCIATES LTD

Practice address

15700 Chapman PL
Montclair, VA 22025-1315

Phone

(703) 370-5533

Fax

(703) 680-9579

NPI assigned

Nov 28, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jerome Louis Dovberg, DPM

Title

President/Ceo

Phone

(703) 370-5533

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1196208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368748800000",
    "number": "1780866178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15700 CHAPMAN PL",
            "city": "MONTCLAIR",
            "state": "VA",
            "postal_code": "220251315",
            "telephone_number": "703-370-5533",
            "fax_number": "703-680-9579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15700 CHAPMAN PL",
            "city": "MONTCLAIR",
            "state": "VA",
            "postal_code": "220251315",
            "telephone_number": "703-370-5533",
            "fax_number": "703-680-9579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTOMAC PODIATRY ASSOCIATES LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-28",
        "last_updated": "2013-05-17",
        "status": "A",
        "authorized_official_last_name": "DOVBERG",
        "authorized_official_first_name": "JEROME",
        "authorized_official_middle_name": "LOUIS",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "703-370-5533",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "VA",
            "license": "0103000339",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09301127",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gregg Louis Kassan, D.D.S.
• Erika Jane Kramer, M.S. CCC-SLP
• Alexis Bernice Martinez
• Alison Patton, RN
• Joanne Perdu-Ouimet, LPC
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• Demarr Joseph-Clay Stewart
• Barbara Wolf, MED, BCBA, LBA

• Podiatrist in Montclair, VA
• Providers in Montclair, VA by specialty
• Podiatrist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2013; 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.