Individual provider Active NPI

Shobha R. Whitacre, PT

  • Physical Therapist
  • Annapolis, MD
National Provider Identifier
1447515168
Registry record updated May 9, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
16360 Issued in MD
Practice address
2000 Medical Pkwy
Ste 101
Annapolis, MD 21401-3742
Phone
(410) 295-8900
Fax
(410) 280-4701
NPI assigned
Jul 9, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 9, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 16360 MD Primary

Addresses

Primary practice location

2000 Medical Pkwy
Ste 101
Annapolis, MD 21401-3742

Mailing address

2000 Medical Pkwy
Ste 101
Annapolis, MD 21401-3742
Phone (410) 295-8900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20120727000248 MD Practitioner - Physical Therapist in Private Practice 8426214982 Reassigns benefits to 1 organization
I20120727000699 DC Practitioner - Physical Therapist in Private Practice 8426214982 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
LHMG Physical Therapy, LLCGroup PAC ID 3870893738, 101 clinicians

Practice addresses (Care Compare)

1106 Annapolis Rd
Suite 120
Odenton, MD 21113-1738
Phone (410) 674-1650

4175 N Hanson Court
Suite 301
Bowie, MD 20716-3179
Phone (301) 805-7004

8109 Ritchie Hwy
Suite 600
Pasadena, MD 21122-6905
Phone (410) 553-3515

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16360MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
LHMG Physical Therapy, LLC Physical Therapist CurrentSince Oct 1, 2015 Accepting new patients
LHMG Physical Therapy, LLC Physical Therapist Current Accepting new patients
Luminis Health Medical Group, LLC Past Accepting new patients

Locations

201 Defense Hwy
Ste 150
Annapolis, MD 21401

2000 Medical Pkwy
Ste 101
Annapolis, MD 21401
Phone (410) 295-8900

201 Defense Hwy
Ste 100
Annapolis, MD 21401
Phone (443) 481-6549

4175 N Hanson Ct
Ste 301
Bowie, MD 20716
Phone (301) 805-0190

15500 Annapolis Rd
Ste 102
Bowie, MD 20715
Phone (301) 805-0190

8638 Veterans Hwy
Fl 1
Millersville, MD 21108
Phone (410) 729-4508

1106 Annapolis Rd
Ste 120
Odenton, MD 21113
Phone (410) 674-1650

8109 Ritchie Hwy
Ste 600
Pasadena, MD 21122
Phone (410) 553-3515

7611 Crain Hwy
Ste C170
Upper Marlboro, MD 20772

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1341792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494288000000",
    "number": "1447515168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 MEDICAL PKWY",
            "address_2": "STE 101",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013742",
            "telephone_number": "410-295-8900",
            "fax_number": "410-280-4701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 MEDICAL PKWY",
            "address_2": "STE 101",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013742",
            "telephone_number": "410-295-8900",
            "fax_number": "410-280-4701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITACRE",
        "first_name": "SHOBHA",
        "middle_name": "R.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-09",
        "last_updated": "2017-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "16360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.