Physical Therapy at Crossroads, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

20452 Issued in MD

Legal business name

PHYSICAL THERAPY AT CROSSROADS, LLC

Practice address

4801 Dorsey Hall Dr Ste 130
Ellicott City, MD 21042-7763

Phone

(443) 393-3788

Fax

(443) 378-3533

NPI assigned

May 5, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Jonathan Schiller, PT, MS

Title

Clinic Director

Phone

(443) 393-3788

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1493942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1519689600000",
    "number": "1164958435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4801 DORSEY HALL DR STE 130",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427763",
            "telephone_number": "443-393-3788",
            "fax_number": "443-378-3533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 DORSEY HALL DR STE 130",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427763",
            "telephone_number": "443-393-3788",
            "fax_number": "443-378-3533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL THERAPY AT CROSSROADS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-05",
        "last_updated": "2018-02-27",
        "status": "A",
        "authorized_official_last_name": "SCHILLER",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "443-393-3788",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT, MS"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MD",
            "license": "20452",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "695106600",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Abitha Priya Perumal
• Mercedes Peterman
• Abby Peterson, LAC
• Amanda Peterson
• Natasha Phillips, LMSW
• Physical Therapy Dynamics, Inc
• Kristen L Pika, PT, DPT
• Carolina Pimenta, RN, BSN, IBCLC
• Kristen G Pinto-Coelho, PHD
• Lisa Marie Pishock, CPCP

• Physical Therapy Clinic/Center in Ellicott City, MD
• Providers in Ellicott City, MD by specialty
• Physical Therapy Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2018; 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.