Plaza Rehabilitation, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

17195 Issued in MD

Legal business name

PLAZA REHABILITATION, LLC

Practice address

1912 Liberty Rd
Sykesville, MD 21784-6602

Phone

(410) 795-7696

Fax

(410) 795-5789

NPI assigned

Nov 29, 2006

Organization subpart

No

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

Authorized official

Name

Edward J Lyons, PTNPI 1427125723

Title

Owner

Phone

(410) 795-7696

Specialties & licenses 1

Addresses

Other identifiers 6

Practitioners 1

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

• Edward J Lyons, PT

  • Physical Therapist
  • Sykesville, MD
  • NPI 1427125723
  NPD (past) Authorized official

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295802593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1912 LIBERTY RD",
            "city": "SYKESVILLE",
            "state": "MD",
            "postal_code": "217846602",
            "telephone_number": "410-795-7696",
            "fax_number": "410-795-5789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1912 LIBERTY RD",
            "city": "SYKESVILLE",
            "state": "MD",
            "postal_code": "217846602",
            "telephone_number": "410-795-7696",
            "fax_number": "410-795-5789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLAZA REHABILITATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LYONS",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-795-7696",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "17195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "3584115",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3584226",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7295156",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "2126696",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST MARYLAND",
            "identifier": "962APL",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHMSI",
            "identifier": "T473",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacqueline Christine Perry
• Gary L Persing, PT
• Sherri Ann Pfisterer, RN
• Physician Group Provider - Springfield Hospital Center
• Pin It Up Acupuncture
• Kirsten Porr
• Powers Counseling and Play Therapy
• William Prestianni, LCPC
• Emaline Printz
• Privia Medical Group, LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.