Individual provider Active NPI

Hadley Johnsonbaugh, DO

  • Military Health Care Provider
  • Bethesda, MD
National Provider Identifier
1831784735
Registry record updated Jul 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Military Health Care ProviderTaxonomy code 171000000X
Practice address
4494 Palmer Rd N
Bethesda, MD 20814
Phone
(301) 295-4781
NPI assigned
Mar 3, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Military Health Care Provider 171000000X Primary

Addresses

Primary practice location

4494 Palmer Rd N
Bethesda, MD 20814

Mailing address

200 Mercy Circle
Oceanside, CA 92055
Phone (562) 242-8095

Other practice location 1

38400 Bob Wilson Dr
San Diego, CA 92134-5000
Phone (562) 242-8095

Other practice location 2

200 Mercy Circle
Oceanside, CA 92055
Phone (562) 242-8095

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240917001791 CA Order and Referring Only - NeurologyPractitioner - Neurology 2961943089

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20126CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1614729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721088000000",
    "number": "1831784735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MERCY CIRCLE",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "92055",
            "telephone_number": "562-242-8095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4494 PALMER RD N",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "20814",
            "telephone_number": "301-295-4781"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "38400 Bob Wilson Dr",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921345000",
            "country_code": "US",
            "telephone_number": "562-242-8095",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "200 Mercy Circle",
            "address_purpose": "LOCATION",
            "city": "Oceanside",
            "state": "CA",
            "postal_code": "92055",
            "country_code": "US",
            "telephone_number": "562-242-8095",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSONBAUGH",
        "first_name": "HADLEY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-03",
        "last_updated": "2024-07-16",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171000000X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

Verify at the official NPI Registry.