Source Physiotherapy LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

SOURCE PHYSIOTHERAPY LLC

Practice address

10155 York Rd Ste 205-206
Cockeysville, MD 21030-3352

Phone

(443) 355-8891

NPI assigned

Jul 20, 2021

Organization subpart

No

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

Authorized official

Name

Emmannouil Lagogiannis, PT, MSC

Title

Physiotherapist

Phone

(443) 355-8891

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Locations

Practitioners 1

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

• Emmanouil Lagogiannis, PT, MSC

  • Physical Therapist
  • Cockeysville, MD
  • NPI 1801464599
  Medicare reassignment NPD

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

{
    "created_epoch": "1626739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1720915200000",
    "number": "1316510282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 HILLSYDE CT",
            "city": "COCKEYSVILLE",
            "state": "MD",
            "postal_code": "210301750",
            "telephone_number": "443-355-8891"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10155 YORK RD STE 205-206",
            "city": "COCKEYSVILLE",
            "state": "MD",
            "postal_code": "210303352",
            "telephone_number": "443-355-8891"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOURCE PHYSIOTHERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-20",
        "last_updated": "2024-07-14",
        "certification_date": "2024-07-14",
        "status": "A",
        "authorized_official_last_name": "LAGOGIANNIS",
        "authorized_official_first_name": "EMMANNOUIL",
        "authorized_official_title_or_position": "PHYSIOTHERAPIST",
        "authorized_official_telephone_number": "443-355-8891",
        "authorized_official_credential": "PT, MSC"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerome Alan Slavitt, DPM
• Emily Small, BCBA
• Smarttrans Ambulance Service
• Smiley Counseling
• Frederick Smith
• Anna Alexandra Spahn, OTR/L
• Leonard Spector, DDS
• Steinmetz Optical Inc
• Stephen C. Flemke,O.D.,P.a.
• Nichole Brooke Stewart, B.A., BCBA

• Physical Therapy Clinic/Center in Cockeysville, MD
• Providers in Cockeysville, MD by specialty
• Physical Therapy Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2024; 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.