NPIMap

Organization Active NPI

Howard County Physical Therapy Sports Rehabilitation

  • Physical Medicine & Rehabilitation Physician
  • Ellicott City, MD
National Provider Identifier
1265428148
Registry record updated Jul 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
HOWARD COUNTY PHYSICAL THERAPY SPORTS REHABILITATION
Practice address
6011 University Blvd
Suite 120
Ellicott City, MD 21043-6074
Phone
(410) 203-0391
Fax
(410) 203-2707
NPI assigned
Sep 26, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2013

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

Authorized official

Name
Lynda G Mules
Title
President / Ceo
Phone
(410) 203-0391

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X MD Primary

Addresses

Primary practice location

6011 University Blvd
Suite 120
Ellicott City, MD 21043-6074

Mailing address

6011 University Blvd
Suite 120
Ellicott City, MD 21043-6074
Phone (410) 203-0391

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040107000511 MD Part B Supplier - Clinic/Group Practice 7214836428 Receives reassigned benefits from 9 practitioners
Practice locations: Ellicott City, MD

National Provider Directory

National Provider Directory

Locations

6011 University Blvd
Ste 120
Ellicott City, MD 21043
Phone (410) 203-0391

Practitioners & affiliated clinicians

Practitioners 9

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

NPI Registry JSON

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

{
    "created_epoch": "1127692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372636800000",
    "number": "1265428148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6011 UNIVERSITY BLVD",
            "address_2": "SUITE 120",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210436074",
            "telephone_number": "410-203-0391",
            "fax_number": "410-203-2707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6011 UNIVERSITY BLVD",
            "address_2": "SUITE 120",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210436074",
            "telephone_number": "410-203-0391",
            "fax_number": "410-203-2707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOWARD COUNTY PHYSICAL THERAPY SPORTS REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-26",
        "last_updated": "2013-07-01",
        "status": "A",
        "authorized_official_last_name": "MULES",
        "authorized_official_first_name": "LYNDA",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT / CEO",
        "authorized_official_telephone_number": "410-203-0391"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2013; 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.