NPIMap

Organization Active NPI

Evolution Sports Physiotherapy - White Marsh, LLC

  • Physical Therapy Clinic/Center
  • Cockeysville, MD
National Provider Identifier
1134519838
Registry record updated Feb 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
20554 Issued in MD
Legal business name
EVOLUTION SPORTS PHYSIOTHERAPY - WHITE MARSH, LLC
Practice address
10540 York Rd
Suite F
Cockeysville, MD 21030-2300
Phone
(443) 955-3515
Fax
(410) 628-0542
NPI assigned
Feb 2, 2015
Last updated
Feb 2, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2015

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

Authorized official

Name
Dr. Morgan Sandford Johnson Jr., PT, DPTNPI 1750490256
Title
Owner / Partnet
Phone
(443) 955-3515

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 20554 MD Primary

Addresses

Primary practice location

10540 York Rd
Suite F
Cockeysville, MD 21030-2300

Mailing address

11605 Crossroads Cir
D-E
Middle River, MD 21220-2865
Phone (443) 955-3515

National Provider Directory

National Provider Directory

Locations

11605 Crossroads Cir
Ste D
Middle River, MD 21220
Phone (410) 628-0520

Practitioners & affiliated clinicians

Practitioners 7

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": "1422835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422835200000",
    "number": "1134519838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11605 CROSSROADS CIR",
            "address_2": "D-E",
            "city": "MIDDLE RIVER",
            "state": "MD",
            "postal_code": "212202865",
            "telephone_number": "443-955-3515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10540 YORK RD",
            "address_2": "SUITE F",
            "city": "COCKEYSVILLE",
            "state": "MD",
            "postal_code": "210302300",
            "telephone_number": "443-955-3515",
            "fax_number": "410-628-0542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVOLUTION SPORTS PHYSIOTHERAPY - WHITE MARSH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-02-02",
        "last_updated": "2015-02-02",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MORGAN",
        "authorized_official_middle_name": "SANDFORD",
        "authorized_official_title_or_position": "OWNER / PARTNET",
        "authorized_official_telephone_number": "443-955-3515",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MD",
            "license": "20554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cockeysville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2015; 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.