NPIMap

Organization Active NPI

Pediatric Therapy Associates, LLC

  • Specialist
  • Silver Spring, MD
National Provider Identifier
1184777203
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
14423 Issued in MD
Legal business name
PEDIATRIC THERAPY ASSOCIATES, LLC
Practice address
12122 Heritage Park Cir # a
Silver Spring, MD 20906-4554
Phone
(301) 942-6006
Fax
(301) 942-4513
NPI assigned
Jan 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Kathleen M Rodriguez, PTNPI 1548313661
Title
Member of LLC
Phone
(301) 942-6006

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 14423 MD Primary

Addresses

Primary practice location

12122 Heritage Park Cir # a
Silver Spring, MD 20906-4554

Mailing address

12122 Heritage Park Cir # a
Silver Spring, MD 20906-4554
Phone (301) 942-6006

Other identifiers 2

IdentifierTypeStateIssuer
A690PEOtherMDCAREFIRST BC BS
S958OtherMDBC BS FEP PLAN

National Provider Directory

National Provider Directory

Locations

12122 Heritage Park Cir
#A
Silver Spring, MD 20906
Phone (301) 942-6006

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1169251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184777203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12122 HERITAGE PARK CIR # A",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209064554",
            "telephone_number": "301-942-6006",
            "fax_number": "301-942-4513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12122 HERITAGE PARK CIR # A",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209064554",
            "telephone_number": "301-942-6006",
            "fax_number": "301-942-4513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC THERAPY ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MEMBER OF LLC",
        "authorized_official_telephone_number": "301-942-6006",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MD",
            "license": "14423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BC BS",
            "identifier": "A690PE",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS FEP PLAN",
            "identifier": "S958",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.