NPIMap

Organization Active NPI

Corey Hall, LLC

  • Physical Therapy Clinic/Center
  • Baltimore, MD
National Provider Identifier
1417570532
Registry record updated Dec 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
COREY HALL, LLC
Practice address
1600 W 41St St Ste 300
Baltimore, MD 21211-1504
Phone
(410) 357-1529
NPI assigned
May 22, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2023

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

Authorized official

Name
Corey Andrew Hall, PT, DPTNPI 1013381839
Title
Owner
Phone
(443) 564-6085

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 Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

1600 W 41St St Ste 300
Baltimore, MD 21211-1504

Mailing address

1636 Aberdeen Rd
Towson, MD 21286-8124
Phone (443) 564-6085

Other practice location 1

47 Loveton Cir Ste P
Sparks, MD 21152-9216
Phone (410) 357-1529

Other names 1

  • Outlast Health and Performance Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240206002951 MD Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8426491564 Receives reassigned benefits from 4 practitioners
Practice locations: Baltimore, MD; Sparks, MD

National Provider Directory

National Provider Directory

Locations

1600 W 41st St
Ste 300
Baltimore, MD 21211
Phone (410) 357-1529

47 Loveton Cir
Ste P
Sparks, MD 21152
Phone (410) 357-1529

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1590105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703894400000",
    "number": "1417570532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1636 ABERDEEN RD",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212868124",
            "telephone_number": "443-564-6085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W 41ST ST STE 300",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212111504",
            "telephone_number": "410-357-1529"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "47 Loveton Cir Ste P",
            "address_purpose": "LOCATION",
            "city": "Sparks",
            "state": "MD",
            "postal_code": "211529216",
            "country_code": "US",
            "telephone_number": "410-357-1529",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COREY HALL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-22",
        "last_updated": "2023-12-30",
        "certification_date": "2023-12-30",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "COREY",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-564-6085",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Outlast Health and Performance",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2023; 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.