Innovative Physical Therapy, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

INNOVATIVE PHYSICAL THERAPY, LLC

Practice address

9470 Annapolis Rd Ste 310
Lanham, MD 20706-3022

Phone

(240) 506-7256

Fax

(240) 770-4303

NPI assigned

Sep 13, 2016

Last updated

Sep 18, 2024By 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

Ramona A Tavares

Title

Owner

Phone

(240) 770-3505

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Locations

Practitioners 3

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.

• Terri Foreman

  • Physical Therapist
  • Catonsville, MD
  • NPI 1376972851

  DC

  Medicare reassignment Care Compare group NPD
• Ivanka Jasmine Tavares

  • Physical Therapist
  • Bowie, MD
  • NPI 1811711369

  DC

  Medicare reassignment Care Compare group NPD
• Kyrel Trim, PT, DPT

  • Physical Therapist
  • Lanham, MD
  • NPI 1609690007

  DC

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1473724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726617600000",
    "number": "1083162515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9470 ANNAPOLIS RD STE 310",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207063022",
            "telephone_number": "240-506-7256",
            "fax_number": "240-770-4303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9470 ANNAPOLIS RD STE 310",
            "city": "LANHAM",
            "state": "MD",
            "postal_code": "207063022",
            "telephone_number": "240-506-7256",
            "fax_number": "240-770-4303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-13",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-18",
        "status": "A",
        "authorized_official_last_name": "TAVARES",
        "authorized_official_first_name": "RAMONA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "240-770-3505"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; 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.