NPIMap

Organization Active NPI

PHS Orthopaedics Rockville

  • Orthopaedic Surgery Physician
  • Rockville, MD
National Provider Identifier
1962771303
Registry record updated Sep 6, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
HFD01-0212 Issued in DC
Legal business name
PHS ORTHOPAEDICS ROCKVILLE
Practice address
9707 Medical Center Dr
Suite 310
Rockville, MD 20850-3348
Phone
(301) 315-6380
Fax
(301) 315-6382
NPI assigned
Dec 14, 2011
Organization subpart
Yes
Parent organization
PROVIDENCE HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Sep 6, 2016

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

Authorized official

Name
Mr. Charles F Haberkern
Title
VP
Phone
(202) 854-4255

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207X00000X HFD01-0212 DC Primary
General Acute Care Hospital 282N00000X HFD01-0212 DC

Addresses

Primary practice location

9707 Medical Center Dr
Suite 310
Rockville, MD 20850-3348

Mailing address

1160 Varnum St NE
St Catherine'S Hall, Room 102
Washington, DC 20017-2107
Phone (202) 854-4069

Other identifiers 3

IdentifierTypeStateIssuer
005145400MedicaidMD
09810714MedicaidVA
029833400MedicaidDC

Other names 1

  • Providence Health Services Other name

National Provider Directory

National Provider Directory
Tax ID family
PHS Ctr for Geriatric Medicine Dp02123 organizations share this tax ID, including this one
Part of
PHS Ctr for Geriatric Medicine Dp021

Other organizations with this tax ID 22

Organizations that report the same tax identification number in the National Provider Directory.

View all 22

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1323820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473120000000",
    "number": "1962771303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1160 VARNUM ST NE",
            "address_2": "ST CATHERINE'S HALL, ROOM 102",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200172107",
            "telephone_number": "202-854-4069",
            "fax_number": "202-854-7825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9707 MEDICAL CENTER DR",
            "address_2": "SUITE 310",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208503348",
            "telephone_number": "301-315-6380",
            "fax_number": "301-315-6382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHS ORTHOPAEDICS ROCKVILLE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PROVIDENCE HOSPITAL",
        "enumeration_date": "2011-12-14",
        "last_updated": "2016-09-06",
        "status": "A",
        "authorized_official_last_name": "HABERKERN",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "202-854-4255",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "DC",
            "license": "HFD01-0212",
            "primary": true
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "DC",
            "license": "HFD01-0212",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005145400",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "09810714",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "029833400",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Providence Health Services",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Sep 6, 2016; 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.