NPIMap

Organization Active NPI

LHMG Physical Therapy, LLC

  • Physical Therapist
  • Easton, MD
National Provider Identifier
1104355189
Registry record updated May 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
LHMG PHYSICAL THERAPY, LLC
Practice address
505 Dutchmans LN Ste A2
Easton, MD 21601-4302
Phone
(410) 822-2440
Fax
(410) 822-2441
NPI assigned
Jun 5, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 24, 2021

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

Authorized official

Name
Peter Odenwald
Title
Vice President
Phone
(443) 481-6415

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

505 Dutchmans LN Ste A2
Easton, MD 21601-4302

Mailing address

8638 Veterans Hwy FL 1
Millersville, MD 21108-1422
Phone (667) 204-7051

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGMedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151201000903 MD Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3870893738 Receives reassigned benefits from 295 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Pasadena, MD; Severna Park, MD; Odenton, MD; Edgewater, MD; Easton, MD; Chester, MD; Annapolis, MD; Gambrills, MD

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

161 Jennifer Rd
Ste A
Annapolis, MD 21401

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1496620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621814400000",
    "number": "1104355189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8638 VETERANS HWY FL 1",
            "city": "MILLERSVILLE",
            "state": "MD",
            "postal_code": "211081422",
            "telephone_number": "667-204-7051",
            "fax_number": "443-481-6515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 DUTCHMANS LN STE A2",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216014302",
            "telephone_number": "410-822-2440",
            "fax_number": "410-822-2441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LHMG PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-06-05",
        "last_updated": "2021-05-24",
        "certification_date": "2021-05-24",
        "status": "A",
        "authorized_official_last_name": "ODENWALD",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "443-481-6415"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PENDING",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Easton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2021; 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.