NPIMap

Organization Active NPI

Optimum Physical Therapy and Wellness, LLC

  • Physical Therapy Clinic/Center
  • Germantown, MD
National Provider Identifier
1326740440
Registry record updated Mar 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
OPTIMUM PHYSICAL THERAPY AND WELLNESS, LLC
Practice address
12800 Middlebrook Rd Ste 100
Germantown, MD 20874-5204
Phone
(301) 235-3031
Fax
(240) 702-0074
NPI assigned
Mar 21, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2023

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

Authorized official

Name
Jarrett Myles ShavitzNPI 1063576304
Title
Owner
Phone
(240) 813-3597

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

12800 Middlebrook Rd Ste 100
Germantown, MD 20874-5204

Mailing address

12800 Middlebrook Rd Ste 100
Germantown, MD 20874-5204
Phone (301) 235-3031

Other names 1

  • Fyzical Therapy and Balance Centers Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Fyzical Therapy and Balance Centers2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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": "1679356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679356800000",
    "number": "1326740440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12800 MIDDLEBROOK RD STE 100",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208745204",
            "telephone_number": "301-235-3031",
            "fax_number": "240-702-0074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12800 MIDDLEBROOK RD STE 100",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "208745204",
            "telephone_number": "301-235-3031",
            "fax_number": "240-702-0074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM PHYSICAL THERAPY AND WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-21",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A",
        "authorized_official_last_name": "SHAVITZ",
        "authorized_official_first_name": "JARRETT",
        "authorized_official_middle_name": "MYLES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "240-813-3597"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fyzical Therapy and Balance Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Germantown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2023; 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.