Active NPI
Lisa Ayd Leydig, PT
- Physical Therapist
- Gambrills, MD
National Provider Identifier
1437212784
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 16648
- Practice address
- 2634 Brandermill Blvd
Gambrills, MD 21054 - Phone
- (410) 721-7201
- Fax
- (410) 721-7580
- NPI assigned
- Dec 18, 2006
- 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 | 16648 | MD | Primary |
Addresses
Primary practice location
2634 Brandermill Blvd
Gambrills, MD 21054
Mailing address
2634 Brandermill Blvd
Gambrills, MD 21054
Phone (410) 721-7201
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16648 | MD | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Professional Sportscare, LLC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- Gambrills, MD
- NPI 1508892761
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1255564800000",
"number": "1437212784",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2634 BRANDERMILL BLVD",
"city": "GAMBRILLS",
"state": "MD",
"postal_code": "21054",
"telephone_number": "410-721-7201",
"fax_number": "410-721-7580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2634 BRANDERMILL BLVD",
"city": "GAMBRILLS",
"state": "MD",
"postal_code": "21054",
"telephone_number": "410-721-7201",
"fax_number": "410-721-7580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEYDIG",
"first_name": "LISA",
"middle_name": "AYD",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-18",
"last_updated": "2009-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "16648",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gambrills, MD
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.