Campus Care Physical Therapy LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

CAMPUS CARE PHYSICAL THERAPY LLC

Practice address

4701 Melbourne PL
College Park, MD 20740-2540

Phone

(240) 907-8898

NPI assigned

Aug 26, 2019

Organization subpart

No

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

Authorized official

Name

Niveditha Jagalur Manjunatha, PT

Title

Physical Therapist

Phone

(240) 907-8898

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1566777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566777600000",
    "number": "1487201224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1053",
            "city": "BELTSVILLE",
            "state": "MD",
            "postal_code": "207041053",
            "telephone_number": "240-907-8898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4701 MELBOURNE PL",
            "city": "COLLEGE PARK",
            "state": "MD",
            "postal_code": "207402540",
            "telephone_number": "240-907-8898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMPUS CARE PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-26",
        "last_updated": "2019-08-26",
        "status": "A",
        "authorized_official_last_name": "JAGALUR MANJUNATHA",
        "authorized_official_first_name": "NIVEDITHA",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "240-907-8898",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2019; 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.