NPIMap

Organization Active NPI

Maryland Sportscare & Rehab, LLC

Doing business as Pivot Physical Therapy of Maryland

  • Physical Therapist
  • Emmitsburg, MD
National Provider Identifier
1154788594
Registry record updated Nov 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
MARYLAND SPORTSCARE & REHAB, LLC
Doing business as
Pivot Physical Therapy of Maryland
Practice address
17750 Creamery Rd
B7
Emmitsburg, MD 21727-9199
Phone
(301) 447-1670
Fax
(301) 447-1671
NPI assigned
Jan 15, 2016
Last updated
Nov 1, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2024

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

Authorized official

Name
Tasheda Broughton, PESC
Title
Manager, Credentialing
Phone
(252) 248-3313

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

17750 Creamery Rd
B7
Emmitsburg, MD 21727-9199

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (252) 248-3313

Other names 1

  • PIVOT PHYSICAL THERAPY OF MARYLAND Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Maryland Sportscare Rehab LLC72 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 21

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 21

Locations

17750 Creamery Rd
#B7
Emmitsburg, MD 21727
Phone (301) 447-1670

NPI Registry JSON

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

{
    "created_epoch": "1452816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730419200000",
    "number": "1154788594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "252-248-3313",
            "fax_number": "410-648-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17750 CREAMERY RD",
            "address_2": "B7",
            "city": "EMMITSBURG",
            "state": "MD",
            "postal_code": "217279199",
            "telephone_number": "301-447-1670",
            "fax_number": "301-447-1671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND SPORTSCARE & REHAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-15",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A",
        "authorized_official_last_name": "BROUGHTON",
        "authorized_official_first_name": "TASHEDA",
        "authorized_official_title_or_position": "MANAGER, CREDENTIALING",
        "authorized_official_telephone_number": "252-248-3313",
        "authorized_official_credential": "PESC"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PIVOT PHYSICAL THERAPY OF MARYLAND",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PIVOT PHYSICAL THERAPY OF MARYLAND",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Emmitsburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2024; 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.