PRO PERFORM SPINAL HEALTH & REHAB LLC (NPI# 1912458621) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912458621 |
| Entity Type | Organization |
| Organization Name | PRO PERFORM SPINAL HEALTH & REHAB LLC |
| Practice Address |
6710 Oxon Hill Rd Suite 400 Oxon Hill MD 20745-1117 |
| Mailing Address |
12070 Old Line Ctr Suite 301 Waldorf MD 20602-2513 |
| Practice Telephone | 3017057800 |
| Practice Fax Number | 3017057888 |
| Mailing Telephone | 3017057800 |
| Mailing Fax Number | 3017057888 |
| Enumeration Date | 2016-10-18 |
| Last Update Date | 2017-02-28 |
| Authorized Official Name | SIMONE SIMMONS (OFFICE MANAGER) |
| Authorized Official Telephone | 3017057800 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 305R00000X | Preferred Provider Organization | S03581 | MD | Managed Care Organizations |
| Street Address |
6710 OXON HILL RD SUITE 400 |
| City | OXON HILL |
| State | MD |
| Zip Code | 20745-1117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922191915 | Dana C. Jackson | Dentist | 6710 Oxon Hill Rd, Suite #350, Oxon Hill, MD 20745-1121 | 2006-10-02 |
| 1992342711 | Dinisha Johnson | Social Worker | 6710 Oxon Hill Rd, Oxon Hill, MD 20745-1117 | 2019-12-01 |
| 1528626819 | Gail Renwick | Social Worker | 6710 Oxon Hill Rd, Oxon Hill, MD 20745-1117 | 2019-05-31 |
| 1104304369 | Brooke Marie Franklin | Occupational Therapy Assistant | 6710 Oxon Hill Rd, Oxon Hill, MD 20745-1117 | 2018-07-31 |
| 1902250582 | Origins Counseling Services, LLC | Community/Behavioral Health | 6710 Oxon Hill Rd, Suite 210, Oxon Hill, MD 20745-1117 | 2016-04-20 |
| 1790176170 | Potomac View Anesthesia, LLC | Anesthesiology | 6710 Oxon Hill Rd, Suite 150, Oxon Hill, MD 20745-1117 | 2015-02-06 |
| 1568867075 | Potomac View Surgery Center, LLC | Clinic/Center | 6710 Oxon Hill Rd, Suite 150, Oxon Hill, MD 20745-1117 | 2014-10-27 |
| 1326486713 | Robert David Waters | Dentist | 6710 Oxon Hill Rd, Suite 350, Oxon Hill, MD 20745-1117 | 2013-06-07 |
| 1699937847 | Tanek L. Jenkins, Dds | Dentist | 6710 Oxon Hill Rd, Suite 170, Oxon Hill, MD 20745-1117 | 2008-06-30 |
| 1275741688 | Motshabi Mamotsumi Makhene-deloach | Dentist | 6710 Oxon Hill Rd, Suite 360, Oxon Hill, MD 20745-1121 | 2007-05-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568086304 | Envue Eye & Laser Center LLC | Ophthalmology | 251 Harbor Blvd, Oxon Hill, MD 20745 | 2020-06-06 |
| 1902441264 | Dean Hasan | Pharmacist | 6163 Oxon Hill Road, National Harbor, MD 20745 | 2019-11-11 |
| 1093360570 | Ebony D Mckinley | Social Worker | 6188 Oxon Hill Road Suite 500, Oxon Hill, MD 20745 | 2019-08-02 |
| 1134691579 | Lisa Mellynchuk | Occupational Therapist | 1400 Nalley Terrance, Room 16, Landover, MD 20745 | 2018-12-26 |
| 1083102438 | Prince George's County Health Department | Family Medicine | 6701 Leyte Drive, Oxon Hill, MD 20745 | 2018-05-01 |
| 1841710746 | Courtnee Carroll | Technician | 5612 Dundalk Dr, Oxon Hill, MD 20745 | 2017-06-21 |
| 1699217679 | Charity Oronos | Physical Therapist | 6981 Oxon Hill Rd, Oxon Hill, MD 20745 | 2016-11-08 |
| 1689004913 | Gerald Jerome Smith | Dentist | 5306 Wheeler Road, Oxon Hill, MD 20745 | 2013-11-22 |
| 1427487644 | Harborside Urgent Care | Clinic/Center | 215 American Way, National Harbor, MD 20745 | 2013-11-07 |
| 1417385840 | Nursing Unlimited Services, Inc | Home Health | 909 East Meadow Ct, Oxon Hill, MD 20745 | 2013-10-22 |
| Find all providers in zip 20745 | ||||
| Taxonomy Code | 305R00000X |
| Grouping | Managed Care Organizations |
| Classification | Preferred Provider Organization |
| A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level. |
| Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/ October 1995, p. 62 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184175440 | Black Nurses Rock - Baltimore. Md Chapter | Preferred Provider Organization | 7017 Hamlet Avenue, Parkville, MD 21234 | 2016-10-20 |
| 1073063632 | Tamieko Ross-anyaso | Preferred Provider Organization | 5919 Lebanon Ln, Elkridge, MD 21075-5142 | 2016-10-07 |
| 1124574744 | I Can't We Can Counseling Center | Preferred Provider Organization | 7060 O(akland Mills Rd, Columbia, MD 21043 | 2016-09-01 |
| 1104273952 | Setif Inc | Preferred Provider Organization | 4920 Niagara Rd Ste 107, College Park, MD 20740-1121 | 2016-05-23 |
| 1518343599 | B& E Ventures Plc | Preferred Provider Organization | 17408 Cherokee Ln, Olney, MD 20832-2163 | 2015-07-31 |
| 1114314150 | Med-ped Healthcare, LLC | Preferred Provider Organization | 4701 Melbourne Pl, College Park, MD 20740-2540 | 2015-04-16 |
| 1306235601 | Hyun Jang | Preferred Provider Organization | 6650 Belair Rd, Baltimore, MD 21206-1874 | 2015-01-10 |
| 1295134005 | Prince Georges County Health Dept. | Preferred Provider Organization | 301 Hampton Park Blvd, Capitol Hgts, MD 20743-3822 | 2014-08-18 |
| 1669881272 | Parker Psychiatric Services, Incorporated | Preferred Provider Organization | 940 Madison Ave Ste 202, Baltimore, MD 21201-2113 | 2014-08-07 |
| 1962788323 | Maryland Rehab and Pain Specialists,llc | Preferred Provider Organization | 5070 Dorsey Hall Dr, Suite 101, Ellicott City, MD 21042-7711 | 2011-10-31 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on PRO PERFORM SPINAL HEALTH & REHAB LLC.
| 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.