NPIMap

Organization Active NPI

Advance Physical Therapy & Sports Rehab. Inc

  • Physical Therapy Clinic/Center
  • Olney, MD
National Provider Identifier
1093954158
Registry record updated Apr 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
18214 Issued in MD
Legal business name
ADVANCE PHYSICAL THERAPY & SPORTS REHAB. INC
Practice address
3411 Olandwood CT
Suite 106
Olney, MD 20832-1488
Phone
(240) 750-9966
Fax
(301) 774-1336
NPI assigned
Feb 12, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2012

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

Authorized official

Name
Ms. Marian Cuba Ruta, D.P.T.NPI 1679787048
Title
President
Phone
(301) 570-3588

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 18214 MD Primary

Addresses

Primary practice location

3411 Olandwood CT
Suite 106
Olney, MD 20832-1488

Mailing address

3411 Olandwood CT
Suite 106
Olney, MD 20832-1488
Phone (240) 750-9966

Other identifiers 1

IdentifierTypeStateIssuer
355103200MedicaidMD

National Provider Directory

National Provider Directory

Locations

3411 Olandwood Ct
Ste 106
Olney, MD 20832
Phone (240) 750-9966

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1234396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334707200000",
    "number": "1093954158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3411 OLANDWOOD CT",
            "address_2": "SUITE 106",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208321488",
            "telephone_number": "240-750-9966",
            "fax_number": "301-774-1336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3411 OLANDWOOD CT",
            "address_2": "SUITE 106",
            "city": "OLNEY",
            "state": "MD",
            "postal_code": "208321488",
            "telephone_number": "240-750-9966",
            "fax_number": "301-774-1336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCE PHYSICAL THERAPY & SPORTS REHAB. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-12",
        "last_updated": "2012-04-18",
        "status": "A",
        "authorized_official_last_name": "RUTA",
        "authorized_official_first_name": "MARIAN",
        "authorized_official_middle_name": "CUBA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "301-570-3588",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "D.P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MD",
            "license": "18214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "355103200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Olney, MD

Sources for this page

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

Verify at the official NPI Registry.