Active NPI
Mary Beth Roca
- Physical Therapist
- Olney, MD
National Provider Identifier
1427574367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 19249
- Practice address
- 18109 Prince Philip Dr Ste 155
Olney, MD 20832-1591 - Phone
- (301) 260-3280
- NPI assigned
- Aug 22, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 19249 | MD | Primary |
Addresses
Primary practice location
18109 Prince Philip Dr Ste 155
Olney, MD 20832-1591
Mailing address
12418 Kondrup Dr
Fulton, MD 20759-9642
Phone (443) 386-8685
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19249 | MD | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1503360000000",
"number": "1427574367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12418 KONDRUP DR",
"city": "FULTON",
"state": "MD",
"postal_code": "207599642",
"telephone_number": "443-386-8685"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18109 PRINCE PHILIP DR STE 155",
"city": "OLNEY",
"state": "MD",
"postal_code": "208321591",
"telephone_number": "301-260-3280"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROCA",
"first_name": "MARY",
"middle_name": "BETH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-22",
"last_updated": "2017-08-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "19249",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Olney, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.