Active NPI
Jonathan Kim, DPT
- Physical Therapist
- Rockville, MD
National Provider Identifier
1871260877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 28575
- Practice address
- 1049 Taft St
Rockville, MD 20850-1309 - Phone
- (240) 515-4775
- NPI assigned
- Aug 26, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 28575 | MD | Primary |
Addresses
Primary practice location
1049 Taft St
Rockville, MD 20850-1309
Mailing address
14112 Jaeger Rd
Clarksburg, MD 20871-9534
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 28575 | Other | MD | STATE BOARD OF PHYSICAL THERAPY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28575 | MD | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Elevated Strength Rehab | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapy Clinic/Center
- Gaithersburg, MD
- NPI 1255195418
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1629936000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629936000000",
"number": "1871260877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14112 JAEGER RD",
"city": "CLARKSBURG",
"state": "MD",
"postal_code": "208719534"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1049 TAFT ST",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208501309",
"telephone_number": "240-515-4775"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIM",
"first_name": "JONATHAN",
"name_prefix": "Dr.",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-08-26",
"last_updated": "2021-08-26",
"certification_date": "2021-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "28575",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE BOARD OF PHYSICAL THERAPY",
"identifier": "28575",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rockville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.