NPIMap

Organization Active NPI

Calvert Physical Therapy and Sports Fitness Center

  • Durable Medical Equipment & Medical Supplies
  • Prince Frederick, MD
National Provider Identifier
1376793364
Registry record updated Jul 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
15757 Issued in MD
Legal business name
CALVERT PHYSICAL THERAPY AND SPORTS FITNESS CENTER
Practice address
220 Solomons Island Rd N
Prince Frederick, MD 20678-3926
Phone
(410) 535-3416
Fax
(410) 414-5930
NPI assigned
Sep 25, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2009

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

Authorized official

Name
Mrs. Deborah J Smootz
Title
Practice Manager
Phone
(410) 414-4846

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 15757 MD Primary

Addresses

Primary practice location

220 Solomons Island Rd N
Prince Frederick, MD 20678-3926

Mailing address

130 Hospital Rd
Suite 103
Prince Frederick, MD 20678-4022
Phone (410) 535-8180

Other identifiers 1

IdentifierTypeStateIssuer
406409703MedicaidMD

National Provider Directory

National Provider Directory
Tax ID family
Calvert Physical Therapy and Sports Fitness Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

130 Hospital Rd
Ste 103
Prnc Frederck, MD 20678
Phone (410) 535-8180

NPI Registry JSON

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

{
    "created_epoch": "1222300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248307200000",
    "number": "1376793364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 HOSPITAL RD",
            "address_2": "SUITE 103",
            "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": "220 SOLOMONS ISLAND RD N",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206783926",
            "telephone_number": "410-535-3416",
            "fax_number": "410-414-5930"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALVERT PHYSICAL THERAPY AND SPORTS FITNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-25",
        "last_updated": "2009-07-23",
        "status": "A",
        "authorized_official_last_name": "SMOOTZ",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "410-414-4846",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MD",
            "license": "15757",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "406409703",
            "state": "MD"
        }
    ],
    "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 Jul 23, 2009; 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.