Active NPI
Jeremy M Larrick, PTA
- Physical Therapy Assistant
- Olney, MD
National Provider Identifier
1497592372
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- A6126
- Practice address
- 18101 Prince Philip Dr
Olney, MD 20832-1514 - Phone
- (301) 774-8882
- NPI assigned
- Jul 9, 2024
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | A6126 | MD | Primary |
Addresses
Primary practice location
18101 Prince Philip Dr
Olney, MD 20832-1514
Mailing address
10139 Fauberg St
Ijamsville, MD 21754-8005
Phone (443) 800-3717
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| A6126 | Other | MD | FSBPT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A6126 | MD | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1720483200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1755043200000",
"number": "1497592372",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10139 FAUBERG ST",
"city": "IJAMSVILLE",
"state": "MD",
"postal_code": "217548005",
"telephone_number": "443-800-3717"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18101 PRINCE PHILIP DR",
"city": "OLNEY",
"state": "MD",
"postal_code": "208321514",
"telephone_number": "301-774-8882"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARRICK",
"first_name": "JEREMY",
"middle_name": "M",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-07-09",
"last_updated": "2025-08-13",
"certification_date": "2025-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MD",
"license": "A6126",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FSBPT",
"identifier": "A6126",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Olney, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.