KOOSHA ADHAM (NPI# 1255951547) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255951547 |
| Entity Type | Individual |
| Full Name | KOOSHA ADHAM |
| Practice Address |
4467 Old Branch Ave Ste 201 Temple Hills MD 20748-1854 |
| Practice Telephone | 3018998900 |
| Mailing Telephone | 3018998900 |
| Enumeration Date | 2020-04-16 |
| Last Update Date | 2020-04-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363L00000X | Nurse Practitioner | AC002818 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
AC002818 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LG0600X |
Nurse Practitioner Specialization: Gerontology |
AC002818 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
AC002818 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
4467 OLD BRANCH AVE STE 201 |
| City | TEMPLE HILLS |
| State | MD |
| Zip Code | 20748-1854 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053630285 | Kasra Adham | Internal Medicine | 4467 Old Branch Ave Ste 201, Temple Hills, MD 20748-1854 | 2010-05-27 |
| 1477065209 | Abdulhosein N Adham | Internal Medicine | 4467 Old Branch Ave Ste 201, Temple Hills, MD 20748-1854 | 2017-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316579873 | Brightway Professionals and Associates | Clinic/Center | 4810 St.barnabas Rd, Suite 201, Temple Hills, MD 20748 | 2020-02-12 |
| 1235783085 | Jasmine Lenee Carter | Behavior Technician | 5506 Clothier St., Temple Hills, MD 20748 | 2019-07-30 |
| 1649760075 | Livewell Family Clinic LLC | Clinic/Center | 3611 Branch Ave Ste 404, Temple Hills, MD 20748 | 2018-05-10 |
| 1346785474 | Cardinal Health Care Solution LLC | Home Health | 4905 Faith Crossin Ct, Templehills, MD 20748 | 2016-12-28 |
| 1205370095 | Crystal Hughes | Specialist | 6337 Old Branch Ave Shop 37, Camp Springs, MD 20748 | 2016-12-13 |
| 1417385444 | Ibhs LLC | Substance Abuse Rehabilitation Facility | 5000 Barnabas Road, Ct2, Temple Hills, MD 20748 | 2013-10-30 |
| 1063848703 | Oluwagbenga Jegede | Home Health Aide | 6516 Allentown Rd, Temple Hills, MD 20748 | 2013-09-25 |
| 1184067514 | Vijaya Lakshmi Alla | Family Medicine | 6014 Old Branch Avenue, Temple Hills, MD 20748 | 2013-04-16 |
| 1215178959 | Patricia Ann Carter | Counselor | 5121 Henderson Road, Suite 101, Temple Hills, MD 20748 | 2009-03-10 |
| 1427220888 | Emerging Vision | Technician/Technologist | 3801 D Branch Ave, Iverson Mall, Temple Hills, MD 20748 | 2008-03-26 |
| Find all providers in zip 20748 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871651778 | Gail A Cavallo | Nurse Practitioner | 6104 Old Branch Ave, Kaiser Permanente Camp Springs Medical Center, Temple Hills, MD 20748-2518 | 2006-12-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346841236 | Golden Oasis Healthcare Services LLC | Nurse Practitioner | 333 Old Line Ave, Laurel, MD 20724-2407 | 2020-11-05 |
| 1225636558 | Agnprx LLC | Nurse Practitioner | 5543 Bonnie Brook Rd, Cambridge, MD 21613-3437 | 2020-10-09 |
| 1417563891 | Barbara Katarzyna Wawryszyn | Nurse Practitioner | 12 Brook Farm Ct Unit E, Perry Hall, MD 21128-9042 | 2020-09-21 |
| 1659981728 | Jamie Briddell | Nurse Practitioner | 250 N Calvert St, Baltimore, MD 21202-3505 | 2020-08-04 |
| 1881202570 | Jisha S Varghese | Nurse Practitioner | 3257 Ramblewood Rd, Ellicott City, MD 21042-2445 | 2020-07-19 |
| 1710505524 | Jillian E Haney | Nurse Practitioner | 208 Plumtree Rd Ste C, Bel Air, MD 21015-6058 | 2020-07-08 |
| 1164040200 | Srkite Associates | Nurse Practitioner | 8 Sudbrook Ln Ste 1a, Pikesville, MD 21208-4132 | 2020-07-06 |
| 1447877279 | Katherine O'bryan | Nurse Practitioner | 176 Thomas Johnson Dr Ste 103, Frederick, MD 21702-4529 | 2020-06-27 |
| 1790300903 | Hall Diabetes Management and Resource Center PC | Nurse Practitioner | 1900 E Northern Pkwy Ste T1, Baltimore, MD 21239-2120 | 2020-06-12 |
| 1376162362 | Thomas Nemer II | Nurse Practitioner | 2225 Old Emmorton Rd Ste 111, Bel Air, MD 21015-6122 | 2020-04-10 |
| Find all providers with the same taxonomy | ||||
| City | TEMPLE HILLS |
| Zip Code | 20748 |
Please comment or provide details below to improve the information on KOOSHA ADHAM.
| 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.