Summerville at Potomac, Inc

Primary specialty

Assisted Living FacilityTaxonomy code 310400000X

License

21AL026-F Issued in MD

Legal business name

SUMMERVILLE AT POTOMAC, INC

Practice address

11215 Seven Locks Rd
Potomac, MD 20854-3260

Phone

(301) 765-9198

Fax

(301) 765-9243

NPI assigned

Nov 18, 2009

Organization subpart

Yes

Parent organization

SUMMERVILLE SENIOR LIVING, INC.As reported in NPPES

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

Authorized official

Name

Noelle Diaz Bickel

Title

Licensing Specialist

Phone

(206) 298-2909

Specialties & licenses 2

Addresses

Other names 1

• Summerville at Potomac Doing business as

Part of

Summerville at St Augustine LLC

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

{
    "created_epoch": "1258502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258502400000",
    "number": "1841528528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 ELLIOTT AVE",
            "address_2": "SUITE 500",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981211044",
            "telephone_number": "206-298-2909",
            "fax_number": "206-301-4500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11215 SEVEN LOCKS RD",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208543260",
            "telephone_number": "301-765-9198",
            "fax_number": "301-765-9243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMERVILLE AT POTOMAC, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SUMMERVILLE SENIOR LIVING, INC.",
        "enumeration_date": "2009-11-18",
        "last_updated": "2009-11-18",
        "status": "A",
        "authorized_official_last_name": "BICKEL",
        "authorized_official_first_name": "NOELLE",
        "authorized_official_middle_name": "DIAZ",
        "authorized_official_title_or_position": "LICENSING SPECIALIST",
        "authorized_official_telephone_number": "206-298-2909"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "MD",
            "license": "21AL026-F",
            "primary": true
        },
        {
            "code": "311500000X",
            "taxonomy_group": "",
            "desc": "Alzheimer Center (Dementia Center)",
            "state": "MD",
            "license": "21AL026-F",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Summerville at Potomac",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Vicki Star, MD
• Maria Graciela Steiger, M.D.
• Merril Stock, MD
• Jodie A Stone, PA-C
• Gertrude Beata Summers, PH.D.
• Summerville at Potomac, LLC
• Summit Ambulatory Surgical Center, LLC
• Alyssa Sy, MT-BC
• Laura Caplan Szabo, LCSW-C
• Mark L Taff, DDS

• Assisted Living Facility in Potomac, MD
• Providers in Potomac, MD by specialty
• Assisted Living Facility in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2009; 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.