Aquafit Physical Therapy, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

19302 Issued in MD

Legal business name

AQUAFIT PHYSICAL THERAPY, LLC

Practice address

8743 Piney Orchard Pkwy
Suite 105
Odenton, MD 21113-2343

Phone

(410) 598-0603

NPI assigned

Oct 15, 2009

Last updated

Oct 15, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ralph Truitt, P.T.NPI 1518070721

Title

Owner

Phone

(410) 598-0603

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Practitioners 3

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.

• Ralph S Truitt, PT

  • Physical Therapist
  • Odenton, MD
  • NPI 1518070721
  Medicare reassignment Care Compare group NPD Authorized official
• Charles Glenn Black, PT

  • Physical Therapist
  • Severn, MD
  • NPI 1053424234
  Medicare reassignment Care Compare group
• Stephanie Kim

  • Physical Therapist
  • Odenton, MD
  • NPI 1245574268
  Medicare reassignment NPD

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

{
    "created_epoch": "1255564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255564800000",
    "number": "1386979995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2208 CREST RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212094207",
            "telephone_number": "410-598-0603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8743 PINEY ORCHARD PKWY",
            "address_2": "SUITE 105",
            "city": "ODENTON",
            "state": "MD",
            "postal_code": "211132343",
            "telephone_number": "410-598-0603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AQUAFIT PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-15",
        "last_updated": "2009-10-15",
        "status": "A",
        "authorized_official_last_name": "TRUITT",
        "authorized_official_first_name": "RALPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-598-0603",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "19302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Odenton, MD
• Providers in Odenton, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2009; 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.