Ashley Lauren Petak, PT

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

License

23818 Issued in MD

Practice address

6208 Montrose Rd
Rockville, MD 20852-4119

Phone

(301) 468-9343

Fax

(301) 230-2127

NPI assigned

Oct 4, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Early Intervention Associates, LLC

  • Physical Therapist
  • Rockville, MD
  • NPI 1447377288
  NPD (past)

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

{
    "created_epoch": "1317686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317686400000",
    "number": "1477837896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6208 MONTROSE RD",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524119",
            "telephone_number": "301-468-9343",
            "fax_number": "301-230-2127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6208 MONTROSE RD",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524119",
            "telephone_number": "301-468-9343",
            "fax_number": "301-230-2127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETAK",
        "first_name": "ASHLEY",
        "middle_name": "LAUREN",
        "name_prefix": "Miss",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-10-04",
        "last_updated": "2011-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "MD",
            "license": "23818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karnisha Person
• Sofia Perugorria
• Ramani Peruvemba, M.D.
• Michael Peskin
• Roli Pessu, PHARMD
• Petek Donmez, MD, P.C.
• Peter Tong DDS PA
• Akintomiwa Peter-Koyi
• Favor Peter
• Grant Peters

• Pediatric Physical Therapist in Rockville, MD
• Providers in Rockville, MD by specialty
• Pediatric Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2011; 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.