NPIMap

Organization Active NPI

Wakefield Physical Therapy, LLC

  • Specialist
  • Grasonville, MD
National Provider Identifier
1124572383
Registry record updated Aug 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
18866 Issued in MD
Legal business name
WAKEFIELD PHYSICAL THERAPY, LLC
Practice address
416 Timber LN
Grasonville, MD 21638-1263
Phone
(410) 991-7880
NPI assigned
Aug 5, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2016

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

Authorized official

Name
Karen Wakefield, P.T.
Title
Physical Therapist, Owner
Phone
(410) 991-7880

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 18866 MD Primary

Addresses

Primary practice location

416 Timber LN
Grasonville, MD 21638-1263

Mailing address

416 Timber LN
Grasonville, MD 21638-1263

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1470355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470355200000",
    "number": "1124572383",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 TIMBER LN",
            "city": "GRASONVILLE",
            "state": "MD",
            "postal_code": "216381263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "416 TIMBER LN",
            "city": "GRASONVILLE",
            "state": "MD",
            "postal_code": "216381263",
            "telephone_number": "410-991-7880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAKEFIELD PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-05",
        "last_updated": "2016-08-05",
        "status": "A",
        "authorized_official_last_name": "WAKEFIELD",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST, OWNER",
        "authorized_official_telephone_number": "410-991-7880",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MD",
            "license": "18866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grasonville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2016; 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.