Active NPI
Joshua Tennant, P.T.
- Physical Therapist
- La Plata, MD
National Provider Identifier
1033304381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 11996
- Practice address
- 103 Centennial St
Suite H
La Plata, MD 20646-5984 - Phone
- (301) 997-0172
- Fax
- (301) 997-0175
- NPI assigned
- Sep 10, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Medicine & Rehabilitation Physician | 208100000X | T6108 | MD | |
| Physical Therapist | 225100000X | 11996 | OH | Primary |
Addresses
Primary practice location
103 Centennial St
Suite H
La Plata, MD 20646-5984
Mailing address
7503 Surratts Rd
Clinton, MD 20735-3358
Phone (301) 870-7001
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T6108 | MD | MD | Physical Medicine & Rehabilitation Physician |
| 11996 | OH | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189382400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328227200000",
"number": "1033304381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7503 SURRATTS RD",
"city": "CLINTON",
"state": "MD",
"postal_code": "207353358",
"telephone_number": "301-870-7001",
"fax_number": "301-870-6697"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 CENTENNIAL ST",
"address_2": "SUITE H",
"city": "LA PLATA",
"state": "MD",
"postal_code": "206465984",
"telephone_number": "301-997-0172",
"fax_number": "301-997-0175"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TENNANT",
"first_name": "JOSHUA",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-09-10",
"last_updated": "2012-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "208100000X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation",
"state": "MD",
"license": "T6108",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OH",
"license": "11996",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Plata, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.