Form and Motion Physical Therapy, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

23736 Issued in MD

Legal business name

FORM AND MOTION PHYSICAL THERAPY, LLC

Practice address

304 B Harry S. Truman Parkway
Annapolis, MD 21401-7449

Phone

(410) 703-6097

NPI assigned

Aug 26, 2011

Last updated

Aug 26, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ingrid PailthorpNPI 1164702783

Title

Owner and Physical Therapist

Phone

(410) 703-6097

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Ingrid Pailthorp

  • Physical Therapist
  • Annapolis, MD
  • NPI 1164702783
  NPD (past) Authorized official

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

{
    "created_epoch": "1314316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314316800000",
    "number": "1073893699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "304 B HARRY S. TRUMAN PARKWAY",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017449"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "304 B HARRY S. TRUMAN PARKWAY",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017449",
            "telephone_number": "410-703-6097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORM AND MOTION PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-26",
        "last_updated": "2011-08-26",
        "status": "A",
        "authorized_official_last_name": "PAILTHORP",
        "authorized_official_first_name": "INGRID",
        "authorized_official_title_or_position": "OWNER AND PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "410-703-6097"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "23736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Piyumi Lanka Fonseka, MD
• Wai Leong Foo, D.O.
• Foot and Ankle Specialists of the Mid-Atlantic, LLC
• Mary Elizabeth Ford, CRNP
• Nicole Monique Ford, LCSW-C
• Dwight Norbert Fortier
• Judith A Foster, ACNP-BC
• Keith Thomas Foster, PH.D.
• Sylvia Foster, MD
• Foundations Therapy LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.