NPIMap

Organization Active NPI

La Plata Physical Therapy

  • Physical Medicine & Rehabilitation Physician
  • La Plata, MD
National Provider Identifier
1376731026
Registry record updated Sep 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
15290 Issued in MD
Legal business name
LA PLATA PHYSICAL THERAPY
Practice address
101 Centennial St
Suite C
La Plata, MD 20646-5975
Phone
(301) 392-3700
Fax
(301) 392-3876
NPI assigned
Oct 9, 2007
Last updated
Sep 5, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2008

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

Authorized official

Name
Jane CunninghamNPI 1619987955
Title
Ceo
Phone
(301) 392-3700

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 Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X 15290 MD Primary

Addresses

Primary practice location

101 Centennial St
Suite C
La Plata, MD 20646-5975

Mailing address

P.O. Box 1732
La Plata, MD 20646
Phone (301) 391-3700

Other identifiers 1

IdentifierTypeStateIssuer
T628OtherDCBLUE CROSS

National Provider Directory

National Provider Directory
Tax ID family
La Plata Physical Therapy2 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 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1191888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220572800000",
    "number": "1376731026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1732",
            "city": "LA PLATA",
            "state": "MD",
            "postal_code": "20646",
            "telephone_number": "301-391-3700",
            "fax_number": "301-392-3876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CENTENNIAL ST",
            "address_2": "SUITE C",
            "city": "LA PLATA",
            "state": "MD",
            "postal_code": "206465975",
            "telephone_number": "301-392-3700",
            "fax_number": "301-392-3876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA PLATA PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-09",
        "last_updated": "2008-09-05",
        "status": "A",
        "authorized_official_last_name": "CUNNINGHAM",
        "authorized_official_first_name": "JANE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "301-392-3700"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MD",
            "license": "15290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "T628",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Plata, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2008; 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.