NPIMap

Organization Active NPI

Leeann Nelson Physical Therapy, LLC

  • Physical Therapist
  • Elkton, MD
National Provider Identifier
1366640120
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
17180 Issued in MD
Legal business name
LEEANN NELSON PHYSICAL THERAPY, LLC
Practice address
410 Maloney Road
Elkton, MD 21921
Phone
(410) 392-9400
Fax
(410) 392-0577
NPI assigned
Jul 3, 2007
Last updated
Jun 11, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Authorized official

Name
Leeann Nelson, PTNPI 1942347901
Title
Owner
Phone
(410) 392-9400

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 17180 MD Primary
Physical Therapist 225100000X NU

Addresses

Primary practice location

410 Maloney Road
Elkton, MD 21921

Mailing address

410 Maloney Road
Elkton, MD 21921-6337
Phone (410) 392-9400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081017000389 MD Part B Supplier - Clinic/Group Practice 0143388306 Receives reassigned benefits from 9 practitioners
Practice locations: Elkton, MD

National Provider Directory

National Provider Directory
Tax ID family
Lee Ann Nelson Physical Therapy LLC2 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.

Locations

107 Chesapeake Blvd
Ste 100
Elkton, MD 21921
Phone (410) 392-9400

4925 Pulaski Hwy
Ste A
Perryville, MD 21903
Phone (410) 642-9100

Practitioners & affiliated clinicians

Practitioners 13

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.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1183420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1366640120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 MALONEY ROAD",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219216337",
            "telephone_number": "410-392-9400",
            "fax_number": "410-392-0577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 MALONEY ROAD",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "21921",
            "telephone_number": "410-392-9400",
            "fax_number": "410-392-0577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEEANN NELSON PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-03",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "LEEANN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-392-9400",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "17180",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elkton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; 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.