NPIMap

Organization Active NPI

Peret & Moy Therapy Associates L.L.C

  • Physical Therapist
  • Stevensville, MD
National Provider Identifier
1508013848
Registry record updated Jun 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
15936 Issued in MD
Legal business name
PERET & MOY THERAPY ASSOCIATES L.L.C
Practice address
460 Main St Ste 104
Stevensville, MD 21666-4078
Phone
(410) 604-2982
Fax
(410) 604-2985
NPI assigned
Aug 19, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2020

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

Authorized official

Name
Laurie Davis
Title
Assistant Office Manager
Phone
(410) 604-2982

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 15936 MD Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 16487 MD
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X 01003 MD
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X

Addresses

Primary practice location

460 Main St Ste 104
Stevensville, MD 21666-4078

Mailing address

460 Main St Ste 104
Stevensville, MD 21666-4078
Phone (410) 604-2982

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090220000231 MD Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6406911791 Receives reassigned benefits from 3 practitioners
Practice locations: Stevensville, MD

National Provider Directory

National Provider Directory

Locations

1630 Main St
Ste 110
Chester, MD 21619
Phone (410) 604-2982

460 Main St
Ste 104
Stevensville, MD 21666
Phone (410) 604-2982

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": "1219104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1591660800000",
    "number": "1508013848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "460 MAIN ST STE 104",
            "city": "STEVENSVILLE",
            "state": "MD",
            "postal_code": "216664078",
            "telephone_number": "410-604-2982",
            "fax_number": "410-604-2985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "460 MAIN ST STE 104",
            "city": "STEVENSVILLE",
            "state": "MD",
            "postal_code": "216664078",
            "telephone_number": "410-604-2982",
            "fax_number": "410-604-2985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERET & MOY THERAPY ASSOCIATES L.L.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-19",
        "last_updated": "2020-06-09",
        "certification_date": "2020-06-09",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_title_or_position": "ASSISTANT OFFICE MANAGER",
        "authorized_official_telephone_number": "410-604-2982"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "15936",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "16487",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "MD",
            "license": "01003",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stevensville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.