Individual provider Active NPI

Ryan Kolb, PT, DPT

  • Physical Therapist
  • Columbia, MD
National Provider Identifier
1174191373
Registry record updated Jun 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
28461 Issued in MD
Practice address
5500 Knoll North Dr Ste 150
Columbia, MD 21045-2476
Phone
(443) 542-0062
NPI assigned
Jun 14, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 28461 MD Primary

Addresses

Primary practice location

5500 Knoll North Dr Ste 150
Columbia, MD 21045-2476

Mailing address

2 E Joppa Rd Apt 1270
Towson, MD 21286-3170

Other identifiers 1

IdentifierTypeStateIssuer
28461OtherMDMARYLAND BOARD OF PHYSICAL THERAPY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210706002140 MD Practitioner - Physical Therapist in Private Practice 3476955030 Reassigns benefits to 2 organizations
I20210706002322 DC Practitioner - Physical Therapist in Private Practice 3476955030 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Glen Burnie Physical Therapy and Sportscare LLCGroup PAC ID 0042102592, 25 clinicians
Maryland Sportscare and Rehab LLCGroup PAC ID 2860440427, 166 clinicians

Practice addresses (Care Compare)

3708 Mountain Rd
Suite D
Pasadena, MD 21122-2025
Phone (410) 255-4833

5500 Knoll N Dr
Suite 150
Columbia, MD 21045-2476
Phone (443) 542-0062

8890 Centre Park Dr
Suite 400
Columbia, MD 21045-2170
Phone (410) 884-6000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28461MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Glen Burnie Physical Therapy & Sportscare, LLC Physical Therapist CurrentSince Jun 15, 2021 Accepting new patients
Glen Burnie Physical Therapy & Sportscare, LLC Physical Therapist CurrentSince Jun 15, 2021 Accepting new patients

Locations

5500 Knoll North Dr
Ste 150
Columbia, MD 21045
Phone (443) 542-0062

14700 Baltimore Ave
Unit 106
Laurel, MD 20707
Phone (240) 754-2203

3708 Mountain Rd
Ste D
Pasadena, MD 21122
Phone (410) 255-4833

350 New Fidelity Ct
Garner, NC 27529
Phone (919) 373-2919

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1623628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1174191373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 E JOPPA RD APT 1270",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212863170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 KNOLL NORTH DR STE 150",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452476",
            "telephone_number": "443-542-0062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLB",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-14",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "28461",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARYLAND BOARD OF PHYSICAL THERAPY",
            "identifier": "28461",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.