NPIMap

Organization Active NPI

Perry Hall Chiropractic & Physical Therapy LLC

  • Chiropractor
  • Baltimore, MD
National Provider Identifier
1457504318
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
PERRY HALL CHIROPRACTIC & PHYSICAL THERAPY LLC
Practice address
8817 Belair Rd
Suite 101
Baltimore, MD 21236-2445
Phone
(410) 256-9650
Fax
(410) 256-3339
NPI assigned
Oct 23, 2008
Last updated
Aug 11, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Authorized official

Name
Dr. Dennis R Travagline, DCNPI 1093713281
Title
Owner/Chiropractor
Phone
(410) 256-9650

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X Primary
Physical Therapist 225100000X

Addresses

Primary practice location

8817 Belair Rd
Suite 101
Baltimore, MD 21236-2445

Mailing address

8817 Belair Rd
Suite 101
Baltimore, MD 21236-2425
Phone (410) 256-9650

Other identifiers 2

IdentifierTypeStateIssuer
N5230000OtherMDGHMSI
F6HFPEOtherMDCARE FIRST BLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081223000376 MD Part B Supplier - Clinic/Group Practice 8325100555 Receives reassigned benefits from 1 practitioner
Practice locations: Baltimore, MD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1224720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660176000000",
    "number": "1457504318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8817 BELAIR RD",
            "address_2": "SUITE 101",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212362425",
            "telephone_number": "410-256-9650",
            "fax_number": "410-256-3339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8817 BELAIR RD",
            "address_2": "SUITE 101",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212362445",
            "telephone_number": "410-256-9650",
            "fax_number": "410-256-3339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERRY HALL CHIROPRACTIC & PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-23",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A",
        "authorized_official_last_name": "TRAVAGLINE",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "410-256-9650",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHMSI",
            "identifier": "N5230000",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARE FIRST BLUE CROSS BLUE SHIELD",
            "identifier": "F6HFPE",
            "state": "MD"
        }
    ],
    "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 Aug 11, 2022; 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.