NPIMap

Organization Active NPI

St. Agnes Healthcare, Inc.

  • Physical Therapist
  • Baltimore, MD
National Provider Identifier
1184923666
Registry record updated Feb 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
ST. AGNES HEALTHCARE, INC.
Practice address
900 Caton Ave
Baltimore, MD 21229-5201
Phone
(667) 234-2149
NPI assigned
Mar 23, 2011
Last updated
Feb 25, 2016By the provider in NPPES
Organization subpart
Yes
Parent organization
ST. AGNES HEALTHCARE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 25, 2016

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

Authorized official

Name
Mr. Keith Vander Kolk
Title
President/Ceo
Phone
(667) 234-2101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

900 Caton Ave
Baltimore, MD 21229-5201

Mailing address

3585 Washington Blvd
Halethorpe, MD 21227-1676
Phone (667) 234-2149

Other names 1

  • St. Agnes Physical Therapy Other name

National Provider Directory

National Provider Directory
Tax ID family
Seton Med GRP41 organizations share this tax ID, including this one
Part of
Seton Med GRP

Other organizations with this tax ID 40

Organizations that report the same tax identification number in the National Provider Directory.

View all 40

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": "1300838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456358400000",
    "number": "1184923666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3585 WASHINGTON BLVD",
            "city": "HALETHORPE",
            "state": "MD",
            "postal_code": "212271676",
            "telephone_number": "667-234-2149",
            "fax_number": "667-234-8644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 CATON AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212295201",
            "telephone_number": "667-234-2149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. AGNES HEALTHCARE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ST. AGNES HEALTHCARE, INC.",
        "enumeration_date": "2011-03-23",
        "last_updated": "2016-02-25",
        "status": "A",
        "authorized_official_last_name": "VANDER KOLK",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "667-234-2101",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "St. Agnes Physical Therapy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.