POTOMAC PODIATRY ASSOCIATES LTD (NPI# 1780866178) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780866178 |
| Entity Type | Organization |
| Organization Name | POTOMAC PODIATRY ASSOCIATES LTD |
| Practice Address |
15700 Chapman Pl Montclair VA 22025-1315 |
| Practice Telephone | 7033705533 |
| Practice Fax Number | 7036809579 |
| Mailing Telephone | 7033705533 |
| Mailing Fax Number | 7036809579 |
| Enumeration Date | 2007-11-28 |
| Last Update Date | 2013-05-17 |
| Authorized Official Name | DR. JEROME LOUIS DOVBERG (PRESIDENT/CEO) |
| Authorized Official Telephone | 7033705533 |
| Authorized Official Credential | DPM |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 0103000339 | VA | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 09301127 | 05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Virginia Business Entities | POTOMAC PODIATRY ASSOCIATES LTD. | 101 South Whiting Street, Alexandria, Virginia 22304 |
| Street Address |
15700 CHAPMAN PL |
| City | MONTCLAIR |
| State | VA |
| Zip Code | 22025-1315 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023622230 | Joanne Perdu-ouimet | Behavioral Analyst | Incredible Changes, 4191 Waterway Dr., Dumfries, VA 22025 | 2020-09-04 |
| 1194287524 | Above and Beyond Therapy LLC | Speech-Language Pathologist | 15389 Autum Ln, Dumfries, VA 22025 | 2019-04-04 |
| 1669954095 | Renee L Roberts | Registered Nurse | 4222 Fortuna Center Plaza Ste 280, Dumfries, VA 22025 | 2018-09-01 |
| 1689044869 | Tracy Agyeman-badu | Pharmacist | 4310 Fortuna Village Center Plaza, Dumfries, VA 22025 | 2015-10-01 |
| 1588054316 | Tiffany Washington | Pharmacy Technician | 16224 Taconic Cir, Dumfries, VA 22025 | 2015-02-02 |
| 1568706158 | Boulevard Center Pediatrics | Pediatrics | 3733 Fettler Park Dr., Dumfries, VA 22025 | 2012-11-20 |
| 1205111796 | Khanh T Le | Pharmacist | 17506 Cajun Ct, Dumfries, VA 22025 | 2011-10-15 |
| 1679737761 | Shailesh K Gohel | Pediatrics | 3733 Fettler Park Dr, Dumfries, VA 22025 | 2008-07-17 |
| 1376616268 | Douglas Kendrick Chan | Physical Therapist | 3767 Fettler Park Drive, Dumfries, VA 22025 | 2006-11-16 |
| 1861596454 | Paul Wells Conrad | Dentist | 16150 Country Club Drive, Dumfries, VA 22025 | 2006-09-12 |
| Find all providers in zip 22025 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417271743 | Chih-hui Tsai | Podiatrist | 4950 San Bernardino St Ste 209, Montclair, CA 91763-2328 | 2010-03-15 |
| 1497856074 | Family Footcare Center of Montclair | Podiatrist | 313 Orange Rd, Montclair, NJ 07042-4451 | 2006-09-26 |
| 1457671257 | Neal S. Yudkoff, Dpm, Pa | Podiatrist | 119 Grove St, Montclair, NJ 07042-4044 | 2010-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255972543 | Achilles Foot Ankle Center Inc | Podiatrist | 681 Hioaks Rd Ste D, Richmond, VA 23225-4043 | 2019-10-08 |
| 1780225078 | Achilles Foot Ankle Center Inc | Podiatrist | 100 Winters St Ste 106, West Point, VA 23181-9534 | 2019-10-08 |
| 1699331710 | Foot and Ankle Specialists of The Mid-atlantic, LLC | Podiatrist | 2210 Executive Dr Ste E, Hampton, VA 23666-6605 | 2019-05-14 |
| 1215419015 | Foot and Ankle Specialists of The Mid-atlantic, LLC | Podiatrist | 530 Sunset Ln Ste A, Culpeper, VA 22701-3981 | 2018-08-29 |
| 1942782743 | Foot and Ankle Specialists of The Mid-atlantic, LLC | Podiatrist | 66 Parkway Ln Ste 102, Fishersville, VA 22939-2385 | 2018-08-29 |
| 1982151577 | Complete Care Medical Group LLC | Podiatrist | 41 Peach Grove Ln, Montross, VA 22520-2756 | 2016-09-01 |
| 1245694488 | Kevin David Rabie | Podiatrist | 3720 Holland Rd Ste 100, Virginia Beach, VA 23452-2859 | 2016-04-13 |
| 1093191280 | Lisa Morse | Podiatrist | 174 Todds Creek Ln, Mathews, VA 23109-2144 | 2015-08-11 |
| 1548642788 | Justin Andrew Phillingane | Podiatrist | 3335 S Crater Rd Ste 500, Petersburg, VA 23805 | 2015-06-24 |
| 1770990764 | Ribeiro Foot and Ankle Center | Podiatrist | 4660 Kenmore Ave Ste 602, Alexandria, VA 22304-1300 | 2014-07-22 |
| Find all providers with the same taxonomy | ||||
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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.