NPIMap

Organization Active NPI

Premise Health of Maryland Medical P C

Doing business as AZ Employee Health and Wellness Center Gaithersburg Physical Therapy

  • Physical Therapy Clinic/Center
  • Gaithersburg, MD
National Provider Identifier
1235942467
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
PREMISE HEALTH OF MARYLAND MEDICAL P C
Doing business as
AZ Employee Health and Wellness Center Gaithersburg Physical Therapy
Practice address
101 Orchard Ridge Dr
Gaithersburg, MD 20878-1917
Phone
(301) 398-6893
Fax
(301) 398-6893
NPI assigned
Jan 30, 2025
Last updated
Jan 30, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2025

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

Authorized official

Name
Jonathan B LeizmanNPI 1447249677
Title
President
Phone
(216) 479-9063

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

101 Orchard Ridge Dr
Gaithersburg, MD 20878-1917

Mailing address

5500 Maryland Way Ste 120
Brentwood, TN 37027-4993
Phone (301) 398-6893

Other names 1

  • AZ Employee Health and Wellness Center Gaithersburg Physical Therapy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Family Health Center Williamsport13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

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

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": "1738195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738195200000",
    "number": "1235942467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MARYLAND WAY STE 120",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274993",
            "telephone_number": "301-398-6893",
            "fax_number": "301-398-6893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 ORCHARD RIDGE DR",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208781917",
            "telephone_number": "301-398-6893",
            "fax_number": "301-398-6893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMISE HEALTH OF MARYLAND MEDICAL P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-01-30",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A",
        "authorized_official_last_name": "LEIZMAN",
        "authorized_official_first_name": "JONATHAN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "216-479-9063"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "AZ Employee Health and Wellness Center Gaithersburg Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gaithersburg, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2025; 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.