NPIMap

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
Organization subpart
No

Authorized official

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

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
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

Specialties & licenses 1

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

Addresses

NPPES NPI Registry

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Oct 25, 2021.

{
    "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.