NPIMap

Organization Active NPI

Pivot Physical Therapy of Central Maryland LLC

  • Physical Therapist
  • Frederick, MD
National Provider Identifier
1255082723
Registry record updated Jan 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PIVOT PHYSICAL THERAPY OF CENTRAL MARYLAND LLC
Practice address
75 Thomas Johnson Dr Ste M
Frederick, MD 21702-4895
Phone
(301) 698-9761
NPI assigned
Jan 15, 2022
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
Tasheda Broughton
Title
Credentialing Manager
Phone
(919) 258-2714

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X

Addresses

Primary practice location

75 Thomas Johnson Dr Ste M
Frederick, MD 21702-4895

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (630) 575-1980

National Provider Directory

National Provider Directory
Tax ID family
Pivot Physical Therapy of Central Maryland LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

3570 Saint Johns Ln
Ellicott City, MD 21042
Phone (410) 461-6776

75 Thomas Johnson Dr
Ste N
Frederick, MD 21702
Phone (301) 663-0009

NPI Registry JSON

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

{
    "created_epoch": "1642204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738195200000",
    "number": "1255082723",
    "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": "630-575-1980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 THOMAS JOHNSON DR STE M",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024895",
            "telephone_number": "301-698-9761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIVOT PHYSICAL THERAPY OF CENTRAL MARYLAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-15",
        "last_updated": "2025-01-30",
        "certification_date": "2025-01-30",
        "status": "A",
        "authorized_official_last_name": "BROUGHTON",
        "authorized_official_first_name": "TASHEDA",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "919-258-2714"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, 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.