Organization Active NPI

Atlantic Rehab, Inc

  • Physical Therapy Clinic/Center
  • Glen Burnie, MD
National Provider Identifier
1003855461
Registry record updated Oct 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
A1924 Issued in MD
Legal business name
ATLANTIC REHAB, INC
Practice address
5 Crain Hwy N
Suite 103
Glen Burnie, MD 21061-2803
Phone
(410) 768-9500
Fax
(410) 768-5200
NPI assigned
Jun 4, 2006
Last updated
Oct 25, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2021

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

Authorized official

Name
Ronald M. Kelch, PTA, MS, JSCC
Title
Director
Phone
(410) 768-9500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X A1924 MD Primary

Addresses

Primary practice location

5 Crain Hwy N
Suite 103
Glen Burnie, MD 21061-2803

Mailing address

5 Crain Hwy N
Suite 103
Glen Burnie, MD 21061-2803
Phone (410) 768-9500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051108000957 MD Part B Supplier - Clinic/Group Practice 2466470463 Receives reassigned benefits from 3 practitioners
Practice locations: Glen Burnie, MD

National Provider Directory

National Provider Directory

Locations

1300 Ritchie Hwy
Ste A
Arnold, MD 21012
Phone (410) 544-6038

5 Crain Hwy N
Ste 103
Glen Burnie, MD 21061
Phone (410) 768-9500

8028 Ritchie Hwy
Ste 207
Pasadena, MD 21122
Phone (410) 296-6232

Practitioners & affiliated clinicians

Practitioners 8

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": "1149379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635120000000",
    "number": "1003855461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 CRAIN HWY N",
            "address_2": "SUITE 103",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210612803",
            "telephone_number": "410-768-9500",
            "fax_number": "410-768-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 CRAIN HWY N",
            "address_2": "SUITE 103",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210612803",
            "telephone_number": "410-768-9500",
            "fax_number": "410-768-5200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC REHAB, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-04",
        "last_updated": "2021-10-25",
        "certification_date": "2021-10-25",
        "status": "A",
        "authorized_official_last_name": "KELCH",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "410-768-9500",
        "authorized_official_credential": "PTA, MS, JSCC"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MD",
            "license": "A1924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2021; 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.