NPIMap

Organization Active NPI

Mid-Atlantic Sports Therapy & Rehabilitation, LLC

  • Physical Therapist
  • Baltimore, MD
National Provider Identifier
1457524738
Registry record updated Apr 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
MID-ATLANTIC SPORTS THERAPY & REHABILITATION, LLC
Practice address
3421 Benson Ave
Suite 100
Baltimore, MD 21227-1056
Phone
(410) 644-1880
Fax
(410) 644-6048
NPI assigned
Apr 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2008

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

Authorized official

Name
Mr. Stephen D Maddock
Title
Chief Executive Officer
Phone
(410) 644-1880

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

3421 Benson Ave
Suite 100
Baltimore, MD 21227-1056

Mailing address

3421 Benson Ave
Suite 100
Baltimore, MD 21227-1056
Phone (410) 644-1880

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207612800000",
    "number": "1457524738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3421 BENSON AVE",
            "address_2": "SUITE 100",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212271056",
            "telephone_number": "410-644-1880",
            "fax_number": "410-644-6048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3421 BENSON AVE",
            "address_2": "SUITE 100",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212271056",
            "telephone_number": "410-644-1880",
            "fax_number": "410-644-6048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MID-ATLANTIC SPORTS THERAPY & REHABILITATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-08",
        "last_updated": "2008-04-08",
        "status": "A",
        "authorized_official_last_name": "MADDOCK",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "410-644-1880",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  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 Apr 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.