Proactive Therapy, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

17825 Issued in MD

Legal business name

PROACTIVE THERAPY, LLC

Practice address

1016 Booth St
Baltimore, MD 21223-2527

Phone

(202) 409-9895

Fax

(202) 470-0423

NPI assigned

Jul 7, 2006

Organization subpart

No

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

Authorized official

Name

Terrell D. Trent, OTNPI 1992898407

Title

Owner

Phone

(202) 409-9895

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Locations

Practitioners 5

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

• Terrell Trent, OTR/L

  • Occupational Therapist
  • Baltimore, MD
  • NPI 1992898407
  Medicare reassignment Care Compare group Authorized official
• Olugbolahan Anifowose

  • Geriatric Physical Therapist
  • Owings Mills, MD
  • NPI 1740715168
  Medicare reassignment Care Compare group NPD
• Asia Blackwell, SLP

  • Speech-Language Pathologist
  • Randallstown, MD
  • NPI 1477079929
  Medicare reassignment NPD
• Jay Walter Neal, P.T.

  • Physical Therapist
  • Owings, MD
  • NPI 1396769329
  Medicare reassignment NPD
• Carmen R Tucker-Richardson, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Towson, MD
  • NPI 1801915079
  Medicare reassignment NPD

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652227200000",
    "number": "1023040128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1016 BOOTH ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212232527",
            "telephone_number": "202-409-9895",
            "fax_number": "202-470-0423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1016 BOOTH ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212232527",
            "telephone_number": "202-409-9895",
            "fax_number": "202-470-0423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-09",
        "status": "A",
        "authorized_official_last_name": "TRENT",
        "authorized_official_first_name": "TERRELL",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "202-409-9895",
        "authorized_official_credential": "OT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "17825",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "MD",
            "license": "04737",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Privia Medical Group, LLC
• Alyson Privitera, LCPC
• Priyallc
• PRN Solutions LLC
• Proactive Behavioral Health Services LLC
• John Calvin Probasco, MD
• Probity Health Inc
• David Procaccini, PHARMD
• Lauren Procaccini, CRNA
• Procare Pharmacy LLC

• Physical Therapist in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2022; 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.