Organization Active NPI

Bayside Physical Therapy and Sports Rehabilitation, Inc.

  • Physical Therapist
  • Millersville, MD
National Provider Identifier
1417009408
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
BAYSIDE PHYSICAL THERAPY AND SPORTS REHABILITATION, INC.
Practice address
8601 Veterans Hwy
Suite 212
Millersville, MD 21108-1547
Phone
(410) 987-2162
NPI assigned
Jan 18, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Nancy Ford
Title
Business Manager
Phone
(410) 956-4308

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

8601 Veterans Hwy
Suite 212
Millersville, MD 21108-1547

Mailing address

3179 Braverton St
Suite 201
Edgewater, MD 21037-2665
Phone (410) 956-4308

National Provider Directory

National Provider Directory

Locations

8601 Veterans Hwy
Ste 212
Millersville, MD 21108
Phone (410) 987-2162

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1417009408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3179 BRAVERTON ST",
            "address_2": "SUITE 201",
            "city": "EDGEWATER",
            "state": "MD",
            "postal_code": "210372665",
            "telephone_number": "410-956-4308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8601 VETERANS HWY",
            "address_2": "SUITE 212",
            "city": "MILLERSVILLE",
            "state": "MD",
            "postal_code": "211081547",
            "telephone_number": "410-987-2162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAYSIDE PHYSICAL THERAPY AND SPORTS REHABILITATION, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "410-956-4308"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Millersville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.