POTOMAC HEALTHCARE ALLIANCE (NPI# 1164775979) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164775979 |
| Entity Type | Organization |
| Organization Name | POTOMAC HEALTHCARE ALLIANCE |
| Practice Address |
198 Thomas Johnson Dr Ste 5 Frederick MD 21702-4449 |
| Practice Telephone | 3016245390 |
| Mailing Telephone | 3016245390 |
| Enumeration Date | 2012-10-17 |
| Last Update Date | 2012-10-17 |
| Authorized Official Name | MR. PATRICK ESKEW (CEO) |
| Authorized Official Telephone | 3016425390 |
| Authorized Official Credential | CEO |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP3300X |
Clinic/Center Specialization: Pain |
10554640 | MD | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MD | NPI | 1215171863 | 01 |
| MD | NPI | 1720248198 | 01 |
| MD | NPI | 1477595916 | 01 |
| Street Address |
198 THOMAS JOHNSON DR STE 5 |
| City | FREDERICK |
| State | MD |
| Zip Code | 21702-4449 |
| 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 | 261QP3300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Pain |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245582832 | Potomac Healthcare Alliance LLC | Clinic/Center | 198 Thomas Johnson Dr, Suite 5, Frederick, MD 21702-4398 | 2012-10-08 |
| 1184971509 | Chronic Pain Treatment Centers | Clinic/Center | 915 Toll House Ave, Suite 103, Frederick, MD 21701-5930 | 2012-08-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669014098 | Maryland Pain and Spine Center, LLC | Clinic/Center | 844 Washington Rd Ste 207, Westminster, MD 21157-6664 | 2019-10-17 |
| 1285196295 | Xpress Medical Specialties, LLC | Clinic/Center | 12200 Annapolis Rd Ste 225, Glenn Dale, MD 20769-9182 | 2019-04-01 |
| 1710453808 | Young Ji Acupuncture Clinic | Clinic/Center | 3459 Saint Johns Ln Ste 9, Ellicott City, MD 21042-4026 | 2018-10-16 |
| 1447755178 | Legacy Spine and Pain, LLC | Clinic/Center | 10421 Motor City Dr # 342430, Bethesda, MD 20817-9996 | 2018-03-26 |
| 1194018085 | Healthy Life Medical Group, Inc | Clinic/Center | 9607 Reisterstown Rd, Owings Mills, MD 21117-4129 | 2011-05-25 |
| 1881917383 | Workwell Physicals Inc | Clinic/Center | 7711 Garrison Rd, Hyattsville, MD 20784-1756 | 2010-03-11 |
| 1548582877 | Alt. Medicine Inc. | Clinic/Center | 3201 Corporate Ct Fl 1, Ellicott City, MD 21042-2247 | 2010-03-01 |
| 1174853626 | Carlos S. Santiago IIi, Mdpc | Clinic/Center | 924 Seton Dr Ste 1, Cumberland, MD 21502-1851 | 2010-01-06 |
| 1295983997 | Qol Pain Management LLC. | Clinic/Center | 3102 N Hilton St, Baltimore, MD 21216-1450 | 2008-09-05 |
| 1174711949 | Surgery Centers of Delmarva, LLC | Clinic/Center | 101 Chesapeake Blvd, Suite C, Elkton, MD 21921-6313 | 2007-10-05 |
| 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.