NPIMap

Organization Active NPI

Chesapeake Physical Medicine,LLC

  • Chiropractor
  • Prince Frederick, MD
National Provider Identifier
1326067562
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
S01463 Issued in MD
Legal business name
CHESAPEAKE PHYSICAL MEDICINE,LLC
Practice address
120 Hospital Rd
Suite100
Prince Frederick, MD 20678-4022
Phone
(410) 535-8180
Fax
(410) 535-8325
NPI assigned
Jul 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Kirk A Conway
Title
Physical Therapist
Phone
(410) 535-8180

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X S01463 MD Primary

Addresses

Primary practice location

120 Hospital Rd
Suite100
Prince Frederick, MD 20678-4022

Mailing address

120 Hospital Rd
Suite100
Prince Frederick, MD 20678-4022
Phone (410) 535-8180

National Provider Directory

National Provider Directory

Locations

120 Hospital Rd
Ste 100
Prnc Frederck, MD 20678
Phone (410) 257-7106

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1326067562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 HOSPITAL RD",
            "address_2": "SUITE100",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206784022",
            "telephone_number": "410-535-8180",
            "fax_number": "410-535-8325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 HOSPITAL RD",
            "address_2": "SUITE100",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206784022",
            "telephone_number": "410-535-8180",
            "fax_number": "410-535-8325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESAPEAKE PHYSICAL MEDICINE,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CONWAY",
        "authorized_official_first_name": "KIRK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "410-535-8180",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "S01463",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prince Frederick, MD

Sources for this page

  • 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.