John Douglass Wallop

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

17006 Issued in MD

Practice address

2661 Riva Rd
BLDG 600, Suite 601
Annapolis, MD 21401-7353

Phone

(410) 266-6626

Fax

(410) 266-3026

NPI assigned

Aug 25, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 6

Other names 1

• Mr. Doug Wallop Other name

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

2 WS LLCGroup PAC ID 4183877277, 5 clinicians

Annapolis Family Physical Therapy, IncGroup PAC ID 9032255401, 8 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

84.06 of 100Reported as group

Quality

83.55

Improvement activities

40

Cost

68.8

Merit-based Incentive Payment System (MIPS)

Final score

90 of 100Reported as individual

Quality

80

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Annapolis Family Physical Therapy, Inc

  • Physical Therapist
  • Annapolis, MD
  • NPI 1336244888
  Medicare reassignment Care Compare group NPD Authorized official
• 2 WS LLC

  • Physical Therapy Clinic/Center
  • Severna Park, MD
  • NPI 1477812451
  Medicare reassignment Care Compare group NPD
• Annapolis Family Physical Therapy, Inc

  • Physical Therapist
  • Annapolis, MD
  • NPI 1104432731
  NPD

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

{
    "created_epoch": "1124928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336521600000",
    "number": "1275526253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2661 RIVA RD",
            "address_2": "BLDG 600, SUITE 601",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017353",
            "telephone_number": "410-266-6626",
            "fax_number": "410-266-3026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2661 RIVA RD",
            "address_2": "BLDG 600, SUITE 601",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214017353",
            "telephone_number": "410-266-6626",
            "fax_number": "410-266-3026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLOP",
        "first_name": "JOHN DOUGLASS",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-25",
        "last_updated": "2012-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "17006",
            "primary": true
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "MD",
            "license": "17006",
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "MD",
            "license": "17006",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MD",
            "license": "17006",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI PROVIDER NUMBER",
            "identifier": "227912",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA NON-HMO NUMBER",
            "identifier": "7947168",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO NUMBER",
            "identifier": "2621453",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC REGION RENDERING #",
            "identifier": "53056502",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS LOCAL #",
            "identifier": "KN59",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC FEDERAL, BLUE CHOICE #",
            "identifier": "W0290002",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DOUG",
            "last_name": "WALLOP",
            "prefix": "MR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Asher Wallace
• Gladys Wallace
• Jenny Wallace
• Scott Andrew Wallace, M.D.
• Marissa I Wallie, D.C.
• John Douglass Wallop II, DPT
• Leslie Ann Wallop, P.T.
• A Terry Walman, MD
• Chantelle Marie Walsh
• Walter C Lockhart

• Physical Therapist in Annapolis, MD
• Providers in Annapolis, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.