# BETHESDA CHEVY CHASE ORTHOPAEDIC ASSOCIATES, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Washington Sports Medicine Institute, Shady Grove Orthopaedics, Washington D.C.- K Street Therapy Office, Jordan-Young Institute
- **Organization subpart:** No

## Provider details

- **NPI number:** 1477583599
- **Authorized official:** CHUCK GRASMEDER (CHIEF ADMINISTRATIVE OFFICER)
- **Authorized official phone:** (240) 482-2412

## Contact information

- **Practice address:** 10215 FERNWOOD RD, \#506, BETHESDA, MD 20817-1106
- **Practice address phone:** (301) 530-1010
- **Mailing address:** 10215 FERNWOOD RD, \#506, BETHESDA, MD 20817-1106
- **Mailing address phone:** (301) 530-1010

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |
| 207XS0106X | Orthopaedic Hand Surgery Physician | — | NULL | — |
| 207XS0106X | Orthopaedic Hand Surgery Physician | — | — | — |
| 207XS0117X | Orthopaedic Surgery of the Spine Physician | — | NULL | — |
| 207XS0117X | Orthopaedic Surgery of the Spine Physician | — | — | — |
| 207XX0004X | Orthopaedic Foot and Ankle Surgery Physician | — | NULL | — |
| 207XX0004X | Orthopaedic Foot and Ankle Surgery Physician | — | — | — |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | — | NULL | — |

## Other

- **Enumeration date:** 07/04/2006
- **Last updated:** 08/19/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 639500700 | — | MD |
| 01 | — | 894071 | PTAN | MD |