Potomac on Call LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

POTOMAC ON CALL LLC

Doing business as

Potomac ElderCare Physicians

Practice address

11215 Seven Locks Rd
Potomac, MD 20854-3260

Phone

(301) 836-1436

NPI assigned

Dec 26, 2019

Organization subpart

No

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

Authorized official

Name

Matthew Bruntel

Title

Provider

Phone

(301) 836-1436

Specialties & licenses 1

Addresses

Other names 1

• Potomac ElderCare Physicians Doing business as

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/21064/brand/1/csg/1/fhir/r4

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

{
    "created_epoch": "1577318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577318400000",
    "number": "1922647775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11100 POWDER HORN DR",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208542539",
            "telephone_number": "202-604-1405"
        },
        {
            "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": "301-836-1436"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTOMAC ON CALL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-26",
        "last_updated": "2019-12-26",
        "certification_date": "2019-12-26",
        "status": "A",
        "authorized_official_last_name": "BRUNTEL",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "301-836-1436"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Potomac ElderCare Physicians",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Potomac Dermatology and Skincare Center
• Potomac Eldercare Physicians
• Potomac Eye Surgeons PA
• Potomac Feeding and Speech LLC
• Potomac Medical Aesthetics, LLC
• Potomac Operator LLC
• Potomac Physical Therapy and Sports Medicine, LLC (Adept Physical Therapy)
• Potomac Prompt Medical Care, LLC
• Potomac Psychiatric Wellness PA
• Jena Elizabeth Powell

• Internal Medicine Physician in Potomac, MD
• Providers in Potomac, MD by specialty
• Internal Medicine Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2019; 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.