NPI 1205501608 · live from the CMS NPI Registry
1st Medical Pain Management Specialists
Clinic/Center, Multi-Specialty in Oxon Hill, MD. National Provider Identifier 1205501608, active.
NPI record
| NPI | 1205501608 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Clinic/Center, Multi-Specialty 261QM1300X |
| Practice location | 5620 Saint Barnabas Rd Ste 340, Oxon Hill, MD 20745 |
| Practice phone | 301-747-4224 |
| Mailing address | 20 Mayo Rd Ste 201, Edgewater, MD 21037 |
| Enumerated | August 9, 2021 |
| Last updated | January 23, 2022 |
| Authorized official | Rosemary Ingado, Clinical Administrator |
| Other names | 1st Medical Painrehab Center |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Counselor, Addiction (Substance Use Disorder) | 101YA0400X | — |
| Counselor, Mental Health | 101YM0800X | — |
| Social Worker, Clinical | 1041C0700X | — |
| Dietitian, Registered, Nutrition, Obesity and Weight Management | 133VN1201X | — |
| Clinic/Center, Adult Mental Health | 261QM0850X | — |
| Clinic/Center, Pain | 261QP3300X | — |
| Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | 261QR0401X | — |
| Clinic/Center, Rehabilitation, Substance Use Disorder | 261QR0405X | — |
| Clinic/Center, Multi-Specialty primary | 261QM1300X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.