Shady Grove Physical Therapy & Rehab Center, LLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

15535 Issued in MD

Legal business name

SHADY GROVE PHYSICAL THERAPY & REHAB CENTER, LLC

Practice address

8907 Shady Grove CT
Gaithersburg, MD 20877-1308

Phone

(301) 921-9818

Fax

(301) 921-0719

NPI assigned

Oct 24, 2007

Organization subpart

No

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

Authorized official

Name

Priti W RainaNPI 1669592911

Title

Partner/Physical Therapist

Phone

(301) 921-9818

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in DC

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sarika Raina, D.P.T.

  • Physical Therapist
  • Gaithersburg, MD
  • NPI 1457569683

  DC

  Medicare reassignment Care Compare group NPD
• Priti W Raina, RPT

  • Orthopedic Physical Therapist
  • Gaithersburg, MD
  • NPI 1669592911
  Care Compare group NPD Authorized official
• Carolyn Dawn Dockins, PT

  • Physical Therapist
  • Rockville, MD
  • NPI 1265608152
  NPD (past)

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

{
    "created_epoch": "1193184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299801600000",
    "number": "1235318403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8907 SHADY GROVE CT",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208771308",
            "telephone_number": "301-921-9818",
            "fax_number": "301-921-0719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8907 SHADY GROVE CT",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208771308",
            "telephone_number": "301-921-9818",
            "fax_number": "301-921-0719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADY GROVE PHYSICAL THERAPY & REHAB CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-24",
        "last_updated": "2011-03-11",
        "status": "A",
        "authorized_official_last_name": "RAINA",
        "authorized_official_first_name": "PRITI",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PARTNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "301-921-9818"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MD",
            "license": "15535",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NPI",
            "identifier": "G00742",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Francheska Seymour, LMSW
• SGR Wellness LLC
• Shady Grove Ambulatory Surgery Center,LLC
• Shady Grove Minimally Invasive
• Shady Grove Modern Dental PC
• Shady Grove Podiatry LLC
• Shady Grove Podiatry, LLC
• Shady Grove Surgery Center LLC
• Victoria Shaffer, LCPC
• Ishita Dushyant Shah

• Specialist in Gaithersburg, MD
• Providers in Gaithersburg, MD by specialty
• Specialist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.