NPIMap

Organization Active NPI

Chesapeake Physical Aquatic Therapy, Inc.

  • Physical Therapist
  • Columbia, MD
National Provider Identifier
1487708178
Registry record updated Jul 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
CHESAPEAKE PHYSICAL AQUATIC THERAPY, INC.
Practice address
7080 Deepage Dr.
Columbia, MD 21045
Phone
(410) 381-7000
Fax
(410) 381-3779
NPI assigned
Jan 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2013

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

Authorized official

Name
Mr. Jared Stewart Goldstein, MPT
Title
Owner/PT
Phone
(410) 381-7000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X Primary
Orthopedic Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2251X0800X

Addresses

Primary practice location

7080 Deepage Dr.
Columbia, MD 21045

Mailing address

7080 Deepage Dr.
Columbia, MD 21045
Phone (410) 381-7000

Other identifiers 2

IdentifierTypeStateIssuer
KBX3OtherMDBLUE SHIELD MD
S429OtherMDBLUE SHIELD DC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372723200000",
    "number": "1487708178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7080 DEEPAGE DR.",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "21045",
            "telephone_number": "410-381-7000",
            "fax_number": "410-381-3779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7080 DEEPAGE DR.",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "21045",
            "telephone_number": "410-381-7000",
            "fax_number": "410-381-3779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHESAPEAKE PHYSICAL AQUATIC THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2013-07-02",
        "status": "A",
        "authorized_official_last_name": "GOLDSTEIN",
        "authorized_official_first_name": "JARED",
        "authorized_official_middle_name": "STEWART",
        "authorized_official_title_or_position": "OWNER/PT",
        "authorized_official_telephone_number": "410-381-7000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD MD",
            "identifier": "KBX3",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD DC",
            "identifier": "S429",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2013; 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.