Resurgent Performance PT

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

25246 Issued in MD

Legal business name

RESURGENT PERFORMANCE PT

Practice address

16810 Oakmont Ave
Gaithersburg, MD 20877-4110

Phone

(240) 261-6136

NPI assigned

Aug 26, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Thomas Frederick Van Ornum, DPT

Title

Owner/Founder

Phone

(240) 261-6136

Specialties & licenses 1

Addresses

Other names 1

• Resurgent Performance Physical Therapy Doing business as

Locations

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

{
    "created_epoch": "1472169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472169600000",
    "number": "1174079545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16810 OAKMONT AVE",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208774110",
            "telephone_number": "240-261-6136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16810 OAKMONT AVE",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208774110",
            "telephone_number": "240-261-6136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESURGENT PERFORMANCE PT",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-26",
        "last_updated": "2016-08-26",
        "status": "A",
        "authorized_official_last_name": "VAN ORNUM",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "FREDERICK",
        "authorized_official_title_or_position": "OWNER/FOUNDER",
        "authorized_official_telephone_number": "240-261-6136",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MD",
            "license": "25246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Resurgent Performance Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Physical Therapy Clinic/Center in Gaithersburg, MD
• Providers in Gaithersburg, 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 Aug 26, 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.