Active NPI
Ernesto Lopez Grecia Jr., PT
- Physical Therapist
- Ellicott, MD
National Provider Identifier
1255597472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 22583
- Practice address
- Executive Center II, 3290 North Ridge Road
Suite 290
Ellicott, MD 21043 - Phone
- (410) 292-4008
- NPI assigned
- Aug 7, 2008
- Last updated
- Aug 7, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 22583 | MD | Primary |
Addresses
Primary practice location
Executive Center II, 3290 North Ridge Road
Suite 290
Ellicott, MD 21043
Mailing address
Executive Center II, 3290 North Ridge Road
Suite 290
Ellicott, MD 21043
Phone (410) 292-4008
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22583 | MD | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1218067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1218067200000",
"number": "1255597472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "EXECUTIVE CENTER II, 3290 NORTH RIDGE ROAD",
"address_2": "SUITE 290",
"city": "ELLICOTT",
"state": "MD",
"postal_code": "21043",
"telephone_number": "410-292-4008"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "EXECUTIVE CENTER II, 3290 NORTH RIDGE ROAD",
"address_2": "SUITE 290",
"city": "ELLICOTT",
"state": "MD",
"postal_code": "21043",
"telephone_number": "410-292-4008"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRECIA",
"first_name": "ERNESTO",
"middle_name": "LOPEZ",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-08-07",
"last_updated": "2008-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "22583",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ellicott, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.