NPIMap

Organization Active NPI

Comprehenisve Primary Care, LLC

  • Family Medicine Physician
  • Rockville, MD
National Provider Identifier
1902862154
Registry record updated Oct 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
H0046438 Issued in MD
Legal business name
COMPREHENISVE PRIMARY CARE, LLC
Practice address
15825 Shady Grove Rd
Suite 140
Rockville, MD 20850-4008
Phone
(301) 869-9776
NPI assigned
Apr 25, 2006
Last updated
Oct 14, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2008

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

Authorized official

Name
Dr. Konstantin Khludenev, MDNPI 1538154075
Title
Managing Partner
Phone
(301) 869-9776

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X R129771 MD
Family Medicine Physician 207Q00000X H0046438 MD Primary
Internal Medicine Physician 207R00000X D0059013 MD

Addresses

Primary practice location

15825 Shady Grove Rd
Suite 140
Rockville, MD 20850-4008

Mailing address

15825 Shady Grove Rd
Suite 140
Rockville, MD 20850-4008
Phone (301) 869-9776

National Provider Directory

National Provider Directory

Locations

15225 Shady Grove Rd
Ste 305
Rockville, MD 20850
Phone (301) 802-4313

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223942400000",
    "number": "1902862154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15825 SHADY GROVE RD",
            "address_2": "SUITE 140",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208504008",
            "telephone_number": "301-869-9776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15825 SHADY GROVE RD",
            "address_2": "SUITE 140",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208504008",
            "telephone_number": "301-869-9776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPREHENISVE PRIMARY CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-25",
        "last_updated": "2008-10-14",
        "status": "A",
        "authorized_official_last_name": "KHLUDENEV",
        "authorized_official_first_name": "KONSTANTIN",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "301-869-9776",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MD",
            "license": "R129771",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "H0046438",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0059013",
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Oct 14, 2008; 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.