Evidence Physical Therapy, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

EVIDENCE PHYSICAL THERAPY, LLC

Doing business as

EvidencePT

Practice address

12150 Annapolis Rd Ste 201
Glenn Dale, MD 20769-9183

Phone

(301) 352-8370

Fax

(301) 352-8372

NPI assigned

Jun 13, 2022

Last updated

Jun 13, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Hassana Moses, SHRM-CP

Title

Practice Administrator

Phone

(301) 352-8370

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• EvidencePT Doing business as

Tax ID family

Evidence Physical Therapy L4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

• Evidence Physical Therapy, LLC

  dba EvidencePT

  • Physical Therapy Clinic/Center
  • Glenn Dale, MD
  • NPI 1831493030
  NPD tax ID
• Evidence Physical Therapy, LLC

  • Physical Therapist
  • Laurel, MD
  • NPI 1972329506
  NPD tax ID
• Evidence Physical Therapy, LLC

  • Physical Therapist
  • Clinton, MD
  • NPI 1982176988
  NPD tax ID

Locations

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.

• Emmanuel Olumuyiwa Moses, PT, DPT, OCS, CCI

  • Physical Therapist
  • Glenn Dale, MD
  • NPI 1588742514

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1655078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655078400000",
    "number": "1265162473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12150 ANNAPOLIS RD STE 201",
            "city": "GLENN DALE",
            "state": "MD",
            "postal_code": "207699183",
            "telephone_number": "301-352-8370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12150 ANNAPOLIS RD STE 201",
            "city": "GLENN DALE",
            "state": "MD",
            "postal_code": "207699183",
            "telephone_number": "301-352-8370",
            "fax_number": "301-352-8372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVIDENCE PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-13",
        "last_updated": "2022-06-13",
        "certification_date": "2022-06-13",
        "status": "A",
        "authorized_official_last_name": "MOSES",
        "authorized_official_first_name": "HASSANA",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "301-352-8370",
        "authorized_official_credential": "SHRM-CP"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "533704600",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPARTMENT OF LABOR",
            "identifier": "616235300",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "533704601",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EvidencePT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Enhanced Care Residential Services LLC
• Marie Enndoh Ndi
• Corlins Epie Nkede
• Emmy L Estrada, PA-C
• Everwell Spine & Rehab LLC
• Evidence Physical Therapy, LLC (EvidencePT)
• Fairwood Internal Medicine
• Faith Transport Inc.
• Kelson Michael Figaro
• Lere Kareem Finnih

• Physical Therapist in Glenn Dale, MD
• Providers in Glenn Dale, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2022; 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.