NPIMap

Organization Active NPI

Maryland Sportscare & Rehab LLC

Doing business as Pivot Physical Therapy of Maryland

  • Physical Therapist
  • Easton, MD
National Provider Identifier
1205451879
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
MARYLAND SPORTSCARE & REHAB LLC
Doing business as
Pivot Physical Therapy of Maryland
Practice address
401 Marvel CT Ste a
Easton, MD 21601-4048
Phone
(410) 820-4449
Fax
(410) 820-4330
NPI assigned
Jun 10, 2020
Last updated
Oct 23, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Authorized official

Name
Tasheda Broughton, PESC
Title
Manager, Credentialing
Phone
(252) 248-3313

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

401 Marvel CT Ste a
Easton, MD 21601-4048

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (252) 248-3313

Other names 1

  • Pivot Physical Therapy of Maryland Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Maryland Sportscare Rehab LLC72 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

401 Marvel Ct
Ste A
Easton, MD 21601
Phone (410) 820-4449

NPI Registry JSON

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

{
    "created_epoch": "1591747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729641600000",
    "number": "1205451879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "252-248-3313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 MARVEL CT STE A",
            "city": "EASTON",
            "state": "MD",
            "postal_code": "216014048",
            "telephone_number": "410-820-4449",
            "fax_number": "410-820-4330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND SPORTSCARE & REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-10",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A",
        "authorized_official_last_name": "BROUGHTON",
        "authorized_official_first_name": "TASHEDA",
        "authorized_official_title_or_position": "MANAGER, CREDENTIALING",
        "authorized_official_telephone_number": "252-248-3313",
        "authorized_official_credential": "PESC"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pivot Physical Therapy of Maryland",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pivot Physical Therapy of Maryland",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Easton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; 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.