PRO-PERFORM SPINAL HEALTH & REHAB LLC (NPI# 1851791735) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851791735 |
| Entity Type | Organization |
| Organization Name | PRO-PERFORM SPINAL HEALTH & REHAB LLC |
| Practice Address |
12070 Old Line Ctr Suite 301 Waldorf MD 20602-2513 |
| Practice Telephone | 3017057800 |
| Mailing Telephone | 3017057800 |
| Enumeration Date | 2014-08-28 |
| Last Update Date | 2014-08-28 |
| Authorized Official Name | EVERETT N SCOTT (PRESIDENT) |
| Authorized Official Telephone | 3017057800 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | S03581 | MD | Chiropractic Providers |
| Street Address |
12070 OLD LINE CTR SUITE 301 |
| City | WALDORF |
| State | MD |
| Zip Code | 20602-2513 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942206412 | Douglas Avery & Associates Ltd | Clinic/Center | 12070 Old Line Ctr, Ste 107, Waldorf, MD 20602-2503 | 2005-06-21 |
| 1104467463 | Maryland Pain & Regenerative Center, LLC | Pain Medicine | 12070 Old Line Ctr, Waldorf, MD 20602-2513 | 2019-10-07 |
| 1578947305 | Larry S. Hotchkiss, Dpm PC | Non-Pharmacy Dispensing Site | 12070 Old Line Ctr, #110, Waldorf, MD 20602-2513 | 2015-07-10 |
| 1427494343 | Denise Colton | Nurse Practitioner | 12070 Old Line Ctr, Suite 302, Waldorf, MD 20602-2513 | 2013-05-18 |
| 1659636082 | Justin G. Pointer | Podiatrist | 12070 Old Line Ctr, Suite 110, Waldorf, MD 20602-2513 | 2012-07-11 |
| 1538437223 | Christine T Gardella | Physician Assistant | 12070 Old Line Ctr, Suite 302, Waldorf, MD 20602-2513 | 2011-12-08 |
| 1265670046 | Dawn Stephanie Christopher | Internal Medicine | 12070 Old Line Ctr, Suite 303, Waldorf, MD 20602-2513 | 2009-02-02 |
| 1548406960 | Surgical Associates, Chartered | Surgery | 12070 Old Line Ctr, Suite 306, Waldorf, MD 20602-2513 | 2009-01-07 |
| 1386812113 | Elizabeth Hurt | Internal Medicine | 12070 Old Line Ctr, Suite 303, Waldorf, MD 20602-2513 | 2008-02-14 |
| 1861682957 | Gowri Kularatna | Internal Medicine | 12070 Old Line Ctr, Suite 200, Waldorf, MD 20602-2513 | 2007-07-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053964957 | Haeyoung Choi | Pharmacist | 25 Smallwood Village Center, Waldorf, MD 20602 | 2019-07-19 |
| 1679137194 | Brighter Days Family Services Inc | Counselor | 11680 Doolittle Dr #111, Waldorf, MD 20602 | 2019-04-30 |
| 1396227039 | Lantern Family Services Inc | Community/Behavioral Health | 11680 Doolittle Dr Ste 111, Waldorf, MD 20602 | 2018-08-29 |
| 1093294910 | Metropolitan Vascular Institute LLC | Internal Medicine | 12070 Old Line Ctr Ste 100, Waldorf, MD 20602 | 2018-08-10 |
| 1174009922 | Dr. Arthur B. Sorkin, D.d.s., LLC | Dentist | 3460 Old Washington Rd., Suite 301-b, Waldorf, MD 20602 | 2018-07-16 |
| 1467945030 | Donna Marie Conley-shaw | Behavior Technician | 16 Pagnell Cir, Waldorf, MD 20602 | 2018-06-08 |
| 1811404296 | Loni Berbaum | Speech-Language Pathologist | 4817 Elmley Pl Apt 315, Waldorf, MD 20602 | 2018-01-06 |
| 1891224853 | Linda E Smith | Social Worker | 605 Pst Office Road, #301, Waldorf, MD 20602 | 2017-06-05 |
| 1104373273 | Love Ngum Che | Pharmacist | 25 Smallwood Village, Waldorf, MD 20602 | 2016-09-07 |
| 1639543341 | Matengy Toure | Pharmacist | 129 St Charles Pkwy, Waldorf, MD 20602 | 2015-11-18 |
| Find all providers in zip 20602 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295020246 | Kennedy Chiropractic PC | Chiropractor | 4140 Crain Hwy, Waldorf, MD 20603-4858 | 2011-06-16 |
| 1245405745 | Elizabeth Jane Rand | Chiropractor | 957 Chandler Ct, Waldorf, MD 20602-2800 | 2008-04-25 |
| 1235304072 | Jess Hunley Crawford IIi | Chiropractor | 975 Chandler Ct, Waldorf, MD 20602-2800 | 2008-04-23 |
| 1366586687 | Life Care Chiropractic and Wellness | Chiropractor | 1 Post Office Rd Ste 102, Waldorf, MD 20602-2714 | 2007-02-19 |
| 1851468995 | Charles Vincent Judge IIi | Chiropractor | 3 Post Office Rd, Suite 104, Waldorf, MD 20602 | 2006-11-30 |
| 1982786737 | Ronda Lynn Sharman | Chiropractor | 1 Post Office Rd, Suite 102, Waldorf, MD 20602-2713 | 2006-10-20 |
| 1932159365 | Edwin L Lipsitz | Chiropractor | 12106 Old Line Ctr, Waldorf, MD 20602-2553 | 2006-05-10 |
| 1295703106 | Shawn Patrick Neville | Chiropractor | 11750 Business Park Dr, Suite 201, Waldorf, MD 20601-2907 | 2006-03-08 |
| 1639724917 | Embrace Chiropractic LLC | Chiropractor | 12106 Old Line Ctr, Waldorf, MD 20602-2553 | 2019-08-05 |
| 1376011916 | Betel Aklilu | Chiropractor | 1 Post Office Rd Ste 102, Waldorf, MD 20602-2714 | 2018-11-12 |
| Find all providers in WALDORF | ||||
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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.