Individual provider Active NPI

Adia Kelly Cobb, M.D.

  • Child & Adolescent Psychiatry Physician
  • Bethesda, MD
National Provider Identifier
1881037331
Registry record updated Sep 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X
License
D0090673 Issued in MD
Practice address
4350 E West Hwy Ste 200
Bethesda, MD 20814-4426
Phone
(301) 970-4001
NPI assigned
Apr 15, 2013
Last updated
Sep 16, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 01080073A IN
Child & Adolescent Psychiatry Physician 2084P0804X 25MA09862600 NJ
Child & Adolescent Psychiatry Physician 2084P0804X 036.145417 IL
Child & Adolescent Psychiatry Physician 2084P0804X D0090673 MD Primary

Addresses

Primary practice location

4350 E West Hwy Ste 200
Bethesda, MD 20814-4426

Mailing address

13926 Hull Street Rd # 2000
Midlothian, VA 23112-2004
Phone (096) 351-3842

Other practice location 1

4525 N Ravenswood Ave Ste 201
Chicago, IL 60640
Phone (312) 857-8794

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036.145417ILMDChild & Adolescent Psychiatry Physician
D0090673MDMDChild & Adolescent Psychiatry Physician
25MA09862600NJMDChild & Adolescent Psychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Psychiatry Current Accepting new patients
Healthy Foundations, LLC CurrentSince May 25, 2021 Accepting new patients
HFG Holdings, LLC PastSince May 25, 2021 Accepting new patients

Locations

4350 East West Hwy
Ste 200
Bethesda, MD 20814
Phone (301) 970-4001

Interoperability endpoints

  • Direct secure messaging: adiacobb@fhcnoi.allscriptsdirect.net
  • Direct secure messaging: adiacobb@tdh.allscriptsdirect.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1365984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1881037331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13926 HULL STREET RD # 2000",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231122004",
            "telephone_number": "096-351-3842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4350 E WEST HWY STE 200",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208144426",
            "telephone_number": "301-970-4001"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4525 N Ravenswood Ave Ste 201",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60640",
            "country_code": "US",
            "telephone_number": "312-857-8794",
            "fax_number": "708-575-8311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COBB",
        "first_name": "ADIA",
        "middle_name": "KELLY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-15",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IN",
            "license": "01080073A",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "NJ",
            "license": "25MA09862600",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "IL",
            "license": "036.145417",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "MD",
            "license": "D0090673",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bethesda, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 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.

Verify at the official NPI Registry.