NPIMap

Organization Active NPI

Potomac Physical Therapy and Sports Medicine, LLC

  • Physical Therapist
  • Potomac, MD
National Provider Identifier
1174079321
Registry record updated Aug 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
20386 Issued in MD
Legal business name
POTOMAC PHYSICAL THERAPY AND SPORTS MEDICINE, LLC
Practice address
7811 Montrose Rd
Suite 350
Potomac, MD 20854-3363
Phone
(301) 213-5700
NPI assigned
Aug 28, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2016

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

Authorized official

Name
Gary Lin, MPTNPI 1538293634
Title
Owner/Physical Therapist
Phone
(301) 213-5700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 20386 MD Primary
Sports Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251S0007X 20386 MD
Orthopedic Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251X0800X 20386 MD

Addresses

Primary practice location

7811 Montrose Rd
Suite 350
Potomac, MD 20854-3363

Mailing address

15521 Peach Leaf LN
North Potomac, MD 20878-2342
Phone (301) 213-5700

Other names 1

  • Adept Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170126001068 DC Part B Supplier - Clinic/Group Practice 7315229341 Receives reassigned benefits from 7 practitioners
Practice locations: Potomac, MD

National Provider Directory

National Provider Directory

Locations

7811 Montrose Rd
Ste 350
Potomac, MD 20854
Phone (301) 213-5700

Practitioners & affiliated clinicians

Practitioners 8

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": "1472342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472342400000",
    "number": "1174079321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15521 PEACH LEAF LN",
            "city": "NORTH POTOMAC",
            "state": "MD",
            "postal_code": "208782342",
            "telephone_number": "301-213-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7811 MONTROSE RD",
            "address_2": "SUITE 350",
            "city": "POTOMAC",
            "state": "MD",
            "postal_code": "208543363",
            "telephone_number": "301-213-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POTOMAC PHYSICAL THERAPY AND SPORTS MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-28",
        "last_updated": "2016-08-28",
        "status": "A",
        "authorized_official_last_name": "LIN",
        "authorized_official_first_name": "GARY",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "301-213-5700",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "20386",
            "primary": true
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Sports",
            "state": "MD",
            "license": "20386",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MD",
            "license": "20386",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Adept Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Potomac, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2016; 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.