Dymentum Health, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

DYMENTUM HEALTH, LLC

Practice address

1615 Rhode Island Ave NE
Washington, DC 20018-1802

Phone

(703) 217-1560

NPI assigned

Nov 15, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Hardley A Coombs

Title

Chief Executive Officer

Phone

(703) 217-1560

Specialties & licenses 1

Addresses

Other names 1

• TCMP Former legal business name

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

{
    "created_epoch": "1479168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493683200000",
    "number": "1891237301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8200 GREENSBORO DR",
            "address_2": "SUITE 900",
            "city": "MC LEAN",
            "state": "VA",
            "postal_code": "221023892",
            "telephone_number": "703-462-5456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 RHODE ISLAND AVE NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200181802",
            "telephone_number": "703-217-1560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYMENTUM HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-15",
        "last_updated": "2017-05-02",
        "status": "A",
        "authorized_official_last_name": "COOMBS",
        "authorized_official_first_name": "HARDLEY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "703-217-1560",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TCMP",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2017; 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.