Individual provider Active NPI

Jennifer E Zabora, DPT

  • Physical Therapist
  • Ellicott City, MD
National Provider Identifier
1194966028
Registry record updated May 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
22581 Issued in MD
Practice address
10300B Baltimore National Pike Ste B
Ellicott City, MD 21042
Phone
(410) 988-5171
Fax
(410) 988-5349
NPI assigned
Mar 24, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2018

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 22581 MD Primary

Addresses

Primary practice location

10300B Baltimore National Pike Ste B
Ellicott City, MD 21042

Mailing address

10300B Baltimore National Pike Ste B
Ellicott City, MD 21042-2128
Phone (410) 988-5171

Other practice location 1

7080 Deepage Dr
Columbia, MD 21045-5219
Phone (410) 381-7000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090408000127 MD Practitioner - Physical Therapist in Private Practice 8729135884 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Maryland School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Revive Physical Therapy LLCGroup PAC ID 0547427627, 6 clinicians

Practice addresses (Care Compare)

10300 Baltimore National Pike
B
Ellicott City, MD 21042-2128
Phone (410) 988-5171

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22581MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Revive Physical Therapy LLC CurrentSince Aug 27, 2012 Accepting new patients

Locations

10300 Baltimore National Pike
#Pb
Ellicott City, MD 21042
Phone (410) 988-5171

10300 Baltimore National Pike
#B
Ellicott City, MD 21042
Phone (410) 988-5171

4920 Waterloo Rd
Ste A
Ellicott City, MD 21043
Phone (410) 750-2270

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1237852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527206400000",
    "number": "1194966028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10300B BALTIMORE NATIONAL PIKE STE B",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210422128",
            "telephone_number": "410-988-5171",
            "fax_number": "410-988-5349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10300B BALTIMORE NATIONAL PIKE STE B",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "21042",
            "telephone_number": "410-988-5171",
            "fax_number": "410-988-5349"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7080 Deepage Dr",
            "address_purpose": "LOCATION",
            "city": "Columbia",
            "state": "MD",
            "postal_code": "210455219",
            "country_code": "US",
            "telephone_number": "410-381-7000",
            "fax_number": "410-381-3779",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ZABORA",
        "first_name": "JENNIFER",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-24",
        "last_updated": "2018-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "22581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2018; 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.