Individual provider Active NPI

Angela Marie Prescott, DPT

  • Physical Therapist
  • College Park, MD
National Provider Identifier
1104053925
Registry record updated Mar 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
22937 Issued in MD
Practice address
4920 Niagara Rd Ste 303
College Park, MD 20740-1110
Phone
(301) 477-1229
Fax
(301) 477-1348
NPI assigned
Jun 19, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 22937 MD Primary

Addresses

Primary practice location

4920 Niagara Rd Ste 303
College Park, MD 20740-1110

Mailing address

4920 Niagara Rd Ste 303
College Park, MD 20740-1110
Phone (301) 477-1229

Other names 1

  • Angela Zavaglia Former name

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
22937MDMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1245369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615766400000",
    "number": "1104053925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4920 NIAGARA RD STE 303",
            "city": "COLLEGE PARK",
            "state": "MD",
            "postal_code": "207401110",
            "telephone_number": "301-477-1229",
            "fax_number": "301-477-1348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4920 NIAGARA RD STE 303",
            "city": "COLLEGE PARK",
            "state": "MD",
            "postal_code": "207401110",
            "telephone_number": "301-477-1229",
            "fax_number": "301-477-1348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESCOTT",
        "first_name": "ANGELA",
        "middle_name": "MARIE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-19",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "22937",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "ZAVAGLIA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in College Park, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2021; 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.