POTOMAC COBBLER, INC (NPI# 1063667434) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063667434 |
| Entity Type | Organization |
| Organization Name | POTOMAC COBBLER, INC |
| Practice Address |
14437 Jefferson Davis Highway Woodbridge VA 22191-2805 |
| Practice Telephone | 7034914222 |
| Practice Fax Number | 7034911040 |
| Mailing Telephone | 7034914222 |
| Mailing Fax Number | 7034911040 |
| Enumeration Date | 2008-11-26 |
| Last Update Date | 2008-11-26 |
| Authorized Official Name | MR. JAMES MARTIN BROWN SR. (SEC/TREAS. POTOMAC COBBER, INC) |
| Authorized Official Telephone | 7034914222 |
| Authorized Official Credential | BOARD CERTIFIED |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 335E00000X | Prosthetic/Orthotic Supplier | 1994 | VA | Suppliers |
| Street Address |
14437 JEFFERSON DAVIS HIGHWAY |
| City | WOODBRIDGE |
| State | VA |
| Zip Code | 22191-2805 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861021131 | Bailey Orthodontics Pllc | Dentist | 16446 Navigation Drive, Woodbridge, VA 22191 | 2020-04-07 |
| 1417589326 | Meseret Abate | Registered Nurse | 15608 William Bayliss Ct, Woodbridge, VA 22191 | 2020-02-08 |
| 1992279327 | Velocity Urgent Care, LLC | Clinic/Center | 16422 Navigation Dr, Woodbridge, VA 22191 | 2019-01-18 |
| 1821577263 | Maame Gyasiwah Banahene | Registered Nurse | 1812 Featherstone Rd, Woodbridge, VA 22191 | 2018-08-07 |
| 1235617507 | Yaw P. Baidoo | Nutritionist | 14960 Potomac Heights Pl Apt 503, Woodbridge, VA 22191 | 2018-07-30 |
| 1477048452 | Anahita Abazari | Optometrist | 14901 Potomac Town Pl, Suite 120, Woodbridge, VA 22191 | 2018-06-22 |
| 1619490661 | Misti S Gray | Nurse Practitioner | 2296 Optiz Blvd, Suite 440, About Women Ob/gyn, Woodbridge, VA 22191 | 2017-07-21 |
| 1568991974 | Patrice Whilby | Behavior Technician | 2264 York Drive Apt 302, Woodbridge, VA 22191 | 2017-06-08 |
| 1508395245 | Maria Theresa Lee | Registered Nurse | 2028b Opitz Blvd # 22191, Woodbridge, VA 22191 | 2017-06-07 |
| 1861943763 | A1 Home Care, LLC | Home Health | 13928 Jefferson Davis Hwy, Ste # C, Woodbridge, VA 22191 | 2016-10-17 |
| Find all providers in zip 22191 | ||||
| Taxonomy Code | 335E00000X |
| Grouping | Suppliers |
| Classification | Prosthetic/Orthotic Supplier |
| An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition. |
| Notes: Source: American Board for Certification in Orthotics, Prosthetics, and Pedorthics, Inc. [7/1/2010: modified, 7/1/2013: modified] Additional Resources: American Board for Certification in Orthotics, Prosthetics and Pedorthics, Inc., www.abcop.org and Board of Certification/Accreditation, International, www.bocusa.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689212078 | Monica Evette Dickenson | Prosthetic/Orthotic Supplier | 2001 Southampton St, Woodbridge, VA 22191-2660 | 2019-12-16 |
| 1568020311 | Vine Beauty Supply | Prosthetic/Orthotic Supplier | 615 Rahway Ave, Woodbridge, NJ 07095-3437 | 2019-06-05 |
| 1720451842 | An Added Touch Salon & Barber LLC | Prosthetic/Orthotic Supplier | 1380 Old Bridge Rd, Woodbridge, VA 22192-2708 | 2015-11-11 |
| 1568714186 | Georgina Aboagye | Prosthetic/Orthotic Supplier | 14230 Smoketown Rd, Woodbridge, VA 22192-4708 | 2012-10-05 |
| 1144410432 | James Martin Brown, Sr. | Prosthetic/Orthotic Supplier | 14437 Jefferson Davis Hwy, Woodbridge, VA 22191-2805 | 2007-08-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548869324 | Reach Orthotic & Prosthetic Service, Inc. | Prosthetic/Orthotic Supplier | 4057 Taylor Rd Ste P, Chesapeake, VA 23321-5527 | 2020-10-22 |
| 1982203709 | Reach Orthotic & Prosthetic Service, Inc. | Prosthetic/Orthotic Supplier | 211 Bulifants Blvd Ste B, Williamsburg, VA 23188-5741 | 2020-10-22 |
| 1225637028 | Reach Orthotic & Prosthetic Service, Inc. | Prosthetic/Orthotic Supplier | 6251 E Virginia Beach Blvd Ste 135, Norfolk, VA 23502-2824 | 2020-10-22 |
| 1326657818 | Hairsonality Rx | Prosthetic/Orthotic Supplier | 110 Coliseum Xing # 5126, Hampton, VA 23666-5971 | 2020-07-30 |
| 1699393850 | Bionic Innovations LLC | Prosthetic/Orthotic Supplier | 896 Haden Ln, Crozet, VA 22932-2833 | 2020-07-13 |
| 1821610361 | Takeria Lewis | Prosthetic/Orthotic Supplier | 300 Karl Linn Dr Apt 115, North Chesterfield, VA 23225-6979 | 2020-05-06 |
| 1033740139 | Hair Saviours | Prosthetic/Orthotic Supplier | 25 Cornerstone Dr, Stafford, VA 22554-6208 | 2020-01-28 |
| 1588202105 | Boston Brace International Inc. | Prosthetic/Orthotic Supplier | 7301 Forest Ave Ste 202, Richmond, VA 23226-3792 | 2019-12-13 |
| 1396388187 | Seven Degree North Hair | Prosthetic/Orthotic Supplier | 700 Lombardy Ave Apt 7402, Newport News, VA 23606-3367 | 2019-10-24 |
| 1598313298 | Reach Orthotic & Prosthetic Service, Inc. | Prosthetic/Orthotic Supplier | 397 Little Neck Rd, Building 3400, Suite 107, Virginia Beach, VA 23452 | 2019-08-27 |
| Find all providers with the same taxonomy | ||||
| City | WOODBRIDGE |
| Zip Code | 22191 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.