POTOMAC SPINE, LLC (NPI# 1083158885) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083158885 |
| Entity Type | Organization |
| Organization Name | POTOMAC SPINE, LLC |
| Practice Address |
1050 Key Pkwy Ste 103 Frederick MD 21702-4496 |
| Mailing Address |
1050 Key Pkwy Suite 202 Frederick MD 21702-4053 |
| Practice Telephone | 2406293982 |
| Mailing Telephone | 2406293990 |
| Enumeration Date | 2016-12-13 |
| Last Update Date | 2018-03-17 |
| Authorized Official Name | KAL KAHLOON (CEO) |
| Authorized Official Telephone | 2406293990 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians | ||
| N | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
Allopathic & Osteopathic Physicians | ||
| N | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 208100000X | Physical Medicine & Rehabilitation | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1050 Key Pkwy Ste 104, Frederick, MD 217024496 | 2406293939 | |
| 12070 Old Line Ctr Ste 205, Waldorf, MD 206022567 | 2406293939 | |
| 12070 Old Line Ctr Ste 210, Waldorf, MD 206022567 | 2406293939 |
| Street Address |
1050 KEY PKWY STE 103 |
| City | FREDERICK |
| State | MD |
| Zip Code | 21702-4496 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932116241 | Ali Razi | Anesthesiology | 1050 Key Pkwy Ste 103, Frederick, MD 21702-4496 | 2006-08-01 |
| 1891264065 | Jodi Lynn Hall | Nurse Practitioner | 1050 Key Pkwy Ste 103, Frederick, MD 21702-4496 | 2018-11-17 |
| 1255846382 | Dennis Prok | Physician Assistant | 1050 Key Pkwy Ste 103, Frederick, MD 21702-4496 | 2017-12-12 |
| 1194230383 | Advanced Pain Management, LLC | Orthopaedic Surgery | 1050 Key Pkwy Ste 103, Frederick, MD 21702 | 2017-12-10 |
| 1194961854 | Advanced Pain Management Services, LLC | Anesthesiology | 1050 Key Pkwy Ste 103, Frederick, MD 21702-4496 | 2008-12-31 |
| 1437317005 | Ojedapo A. Ojeyemi | Orthopaedic Surgery | 1050 Key Pkwy Ste 103, Frederick, MD 21702-4496 | 2008-05-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073129714 | Rita Akowuah | Nurse Practitioner | 1302 Baker Place East Apt 14, Frederick, MD 21702 | 2020-09-18 |
| 1912416272 | Morgan Nicely | Behavior Technician | 65 Thomas Johnson Drive Suite A, Frederick, MD 21702 | 2017-09-29 |
| 1154840494 | Centers for Advanced Orthopaedics, LLC | Orthopaedic Surgery | 184 Thomas Johnson Dr Ste 104, Frederick, MD 21702 | 2017-09-19 |
| 1831617471 | Hazel Elizabeth Gill | Physical Therapy Assistant | 2007 Butterfield Overlook, Frederick, MD 21702 | 2017-09-05 |
| 1831610161 | William Haynes | Nurse Practitioner | 103 Water Land Ct., Frederick, MD 21702 | 2017-06-27 |
| 1497299333 | Timothy Stimach | Pharmacist | 1430b W Patrick St, Frederick, MD 21702 | 2016-12-12 |
| 1184167405 | Maryland Nutrition and Diet Services, L.L.C. | Dietitian, Registered | 1301 W. 7th Street, No. 1607, Frederick, MD 21702 | 2016-11-18 |
| 1649649468 | Oluwakemi Olubunmi Osidele | Nurse Practitioner | 188 Thomas Johnson Dr Ste 102, Frederick, MD 21702 | 2015-09-22 |
| 1841678562 | Ventzislava Hristova | Spec/Tech, Pathology | 1050 Boyles St. Building 560 Room 12-39, National Cancer Institute - Frederick, Frederick, MD 21702 | 2015-05-14 |
| 1023404571 | Mychal Lynn Pilia | Advanced Practice Midwife | 7420 Hayward Road, Suite 104, Frederick, MD 21702 | 2015-04-11 |
| Find all providers in zip 21702 | ||||
| Taxonomy Code | 208100000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Physical medicine and rehabilitation, also referred to as rehabilitation medicine, is the medical specialty concerned with diagnosing, evaluating, and treating patients with physical disabilities. These disabilities may arise from conditions affecting the musculoskeletal system such as neck and back pain, sports injuries, or other painful conditions affecting the limbs, such as carpal tunnel syndrome. Alternatively, the disabilities may result from neurological trauma or disease such as spinal cord injury, head injury or stroke. A physician certified in physical medicine and rehabilitation is often called a physiatrist. The primary goal of the physiatrist is to achieve maximal restoration of physical, psychological, social and vocational function through comprehensive rehabilitation. Pain management is often an important part of the role of the physiatrist. For diagnosis and evaluation, a physiatrist may include the techniques of electromyography to supplement the standard history, physical, x-ray and laboratory examinations. The physiatrist has expertise in the appropriate use of therapeutic exercise, prosthetics (artificial limbs), orthotics and mechanical and electrical devices. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Physical Medicine and Rehabilitation, 2007. http://www.abpmr.org/. American Osteopathic Board of Physical Medicine and Rehabilitation, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Physical Medicine and Rehabilitation. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Physical Medicine and Rehabilitation. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821448085 | Ali Khawaja Md Pllc | Physical Medicine & Rehabilitation | 3713 Mackall St, Frederick, MD 21704-7934 | 2016-06-20 |
| 1093790024 | Mark Roberto Acierno | Physical Medicine & Rehabilitation | 84 Thomas Johnson Ct, Suite B, Frederick, MD 21702-4348 | 2005-12-13 |
| 1811461643 | Leah Pfister | Physical Medicine & Rehabilitation | 7407 Willow Rd, Frederick, MD 21702-2500 | 2019-01-15 |
| 1295209054 | Joanna Catherine Yorks Schuster | Physical Medicine & Rehabilitation | 7407 Willow Rd, Frederick, MD 21702-2500 | 2019-01-15 |
| 1336677905 | Caleb Fatzinger | Physical Medicine & Rehabilitation | 1341 Hughes Ford Rd Ste 104, Frederick, MD 21701-3134 | 2017-05-26 |
| 1447519491 | Nisenfeld & Chilton, Md, Pa | Physical Medicine & Rehabilitation | 86 Thomas Johnson Ct, Frederick, MD 21702-4348 | 2012-05-11 |
| 1871807818 | Matthew S. Roh | Physical Medicine & Rehabilitation | 1050 Key Pkwy, Suite 103, Frederick, MD 21702-4053 | 2010-08-02 |
| 1689659633 | Lisa Perkins Houck | Physical Medicine & Rehabilitation | 610 Solarex Ct, Frederick, MD 21703-8624 | 2005-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538766167 | Amit Grewal | Physical Medicine & Rehabilitation | 222 E Saratoga St Ste 813, Baltimore, MD 21202-3543 | 2020-10-06 |
| 1548877426 | Shaynee Ann Barcelona Araneta | Physical Medicine & Rehabilitation | 17303 Kilpatrick Ct, Hagerstown, MD 21740 | 2020-09-25 |
| 1750992350 | Katrina Marie Mamuzich | Physical Medicine & Rehabilitation | 485 Ritchie Hwy Ste 202, Severna Park, MD 21146-2918 | 2020-08-17 |
| 1427688647 | Rachel Lyn Gochnauer | Physical Medicine & Rehabilitation | 802 Champions Ct, Reisterstown, MD 21136-1751 | 2020-01-16 |
| 1659919793 | Monica Yoon | Physical Medicine & Rehabilitation | 1602 Waverly Way, Baltimore, MD 21239-2309 | 2019-12-19 |
| 1205473014 | Arthur Nwangwu Jr. | Physical Medicine & Rehabilitation | 1911 Belle Haven Dr Apt 303, Landover, MD 20785-4062 | 2019-12-01 |
| 1962043760 | Quantum Rehabilitation Medicine | Physical Medicine & Rehabilitation | 12150 Annapolis Rd Ste 211, Glenn Dale, MD 20769-9183 | 2019-10-02 |
| 1265080113 | Alyssa Semones | Physical Medicine & Rehabilitation | 4944 Wyaconda Rd, Rockville, MD 20852-2444 | 2019-09-03 |
| 1861048472 | Courtney Fields | Physical Medicine & Rehabilitation | 7617 Allendale Dr, Hyattsville, MD 20785-4106 | 2019-08-11 |
| 1700430907 | William K. Smith | Physical Medicine & Rehabilitation | 4301 Jones Bridge Rd Rm 1036, Bethesda, MD 20814-4712 | 2019-07-26 |
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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.