Peninsula Rehabilitation & Sports Medicine, Inc.

Primary specialty

Sports Physical TherapistTaxonomy code 2251S0007X

License

19831 Issued in MD

Legal business name

PENINSULA REHABILITATION & SPORTS MEDICINE, INC.

Practice address

12417 Ocean Gtwy Ste 9
Ocean City, MD 21842-9522

Phone

(410) 213-7878

Fax

(410) 213-7879

NPI assigned

Sep 22, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Lesley K. Rogan, M.ED., PT, ATC

Title

Vice President

Phone

(410) 213-7878

Specialties & licenses 3

Addresses

Other names 1

• Peninsula Rehab & Sports Medicine, Inc. Doing business as

Locations

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185408000000",
    "number": "1407955651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12417 OCEAN GTWY STE 9",
            "city": "OCEAN CITY",
            "state": "MD",
            "postal_code": "218429522",
            "telephone_number": "410-213-7878",
            "fax_number": "410-213-7879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12417 OCEAN GTWY STE 9",
            "city": "OCEAN CITY",
            "state": "MD",
            "postal_code": "218429522",
            "telephone_number": "410-213-7878",
            "fax_number": "410-213-7879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA REHABILITATION & SPORTS MEDICINE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2007-07-26",
        "status": "A",
        "authorized_official_last_name": "ROGAN",
        "authorized_official_first_name": "LESLEY",
        "authorized_official_middle_name": "K.",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "410-213-7878",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.ED., PT, ATC"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "19831",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "19532",
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Sports",
            "state": "MD",
            "license": "19831",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peninsula Rehab & Sports Medicine, Inc.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ocean City Primary Care
• Ocean Wellness
• Caleb Wesley Page Jr., MD
• Peninsula Pain Management, LLC
• Peninsula Rehab & Sports Medicine, Inc.
• Thomas T Penroach, M.D.
• Lisa Ann Peppers, PSY.D.
• Maia Perone, CNS
• Gina Petruzzo
• Stanley Russel Pillemer, MD

• Sports Physical Therapist in Ocean City, MD
• Providers in Ocean City, MD by specialty
• Sports Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2007; 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.