Individual provider Active NPI

Liam Traynor

  • Physical Therapist
  • Baltimore, MD
National Provider Identifier
1457022659
Registry record updated Sep 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
1264 E Joppa Rd Ste 200
Baltimore, MD 21286-5826
Phone
(443) 921-3198
NPI assigned
Sep 27, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2021

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 Primary

Addresses

Primary practice location

1264 E Joppa Rd Ste 200
Baltimore, MD 21286-5826

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20211008000906 MD Practitioner - Physical Therapist in Private Practice 0749688547 Reassigns benefits to 2 organizations
I20221020002129 NY Practitioner - Physical Therapist in Private Practice 0749688547 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28674MDMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Ati Holdings, LLC Physical Therapist CurrentSince Sep 21, 2021 Accepting new patients
Ati Holdings, LLC Physical Therapist CurrentSince Sep 21, 2021 Accepting new patients
Chittenango Physical Therapy, P.C. Physical Therapist CurrentSince Sep 1, 2022 Accepting new patients
Ati Holdings, LLC Past Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

1510 Rock Spring Rd
Ste C
Forest Hill, MD 21050
Phone (410) 420-3619

52 Rising Sun Town Ctr
Rising Sun, MD 21911
Phone (410) 658-0100

1409 S Salisbury Blvd
Unit Cd
Salisbury, MD 21801
Phone (667) 330-1061

1264 E Joppa Rd
Ste 200
Towson, MD 21286
Phone (443) 921-3198

1398 State Route 5
Chittenango, NY 13037
Phone (315) 510-3372

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": "1632700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632700800000",
    "number": "1457022659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1264 E JOPPA RD STE 200",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212865826",
            "telephone_number": "443-921-3198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAYNOR",
        "first_name": "LIAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-27",
        "last_updated": "2021-09-27",
        "certification_date": "2021-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Sep 27, 2021; 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.