NPIMap

Organization Active NPI

Performance Physical Therapy and Sports Rehabilitation LLC

  • Sports Medicine (Physical Medicine & Rehabilitation) Physician
  • Columbia, MD
National Provider Identifier
1003313966
Registry record updated Mar 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081S0010X
Legal business name
PERFORMANCE PHYSICAL THERAPY AND SPORTS REHABILITATION LLC
Practice address
9194 Red Branch Rd Ste J
Columbia, MD 21045-2005
Phone
(410) 997-2585
Fax
(410) 997-2586
NPI assigned
Apr 9, 2018
Last updated
Mar 18, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kerry Hickerson Hite, DPTNPI 1427327642
Title
Owner/Physical Therapist
Phone
(410) 997-2585

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Physical Medicine & Rehabilitation) Physician 2081S0010X Primary
Orthopedic Physical Therapist 2251X0800X
Physical Therapy Clinic/Center 261QP2000X

Addresses

Primary practice location

9194 Red Branch Rd Ste J
Columbia, MD 21045-2005

Mailing address

9194 Red Branch Rd Ste J
Columbia, MD 21045-2005
Phone (410) 997-2585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180524000024 MD Part B Supplier - Clinic/Group Practice 0648535526 Receives reassigned benefits from 6 practitioners
Practice locations: Columbia, MD

National Provider Directory

National Provider Directory

Locations

5501 Twin Knolls Rd
Ste 111
Columbia, MD 21045
Phone (240) 243-0055

9194 Red Branch Rd
Ste J
Columbia, MD 21045
Phone (410) 997-2585

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1523232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742256000000",
    "number": "1003313966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9194 RED BRANCH RD STE J",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452005",
            "telephone_number": "410-997-2585",
            "fax_number": "410-997-2586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9194 RED BRANCH RD STE J",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452005",
            "telephone_number": "410-997-2585",
            "fax_number": "410-997-2586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFORMANCE PHYSICAL THERAPY AND SPORTS REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-09",
        "last_updated": "2025-03-18",
        "certification_date": "2025-03-18",
        "status": "A",
        "authorized_official_last_name": "HITE",
        "authorized_official_first_name": "KERRY",
        "authorized_official_middle_name": "HICKERSON",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "410-997-2585",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "2081S0010X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.