NPIMap

Organization Active NPI

Life Fitness Physical Therapy LLC

  • Physical Therapist
  • Towson, MD
National Provider Identifier
1508103862
Registry record updated Jan 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
LIFE FITNESS PHYSICAL THERAPY LLC
Practice address
658 Kenilworth Dr
Suite 100
Towson, MD 21204-2312
Phone
(410) 339-4600
Fax
(410) 339-4601
NPI assigned
Jan 7, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2013

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

Authorized official

Name
Richard Binstein
Title
VP, Authorized Official
Phone
(713) 297-7000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

658 Kenilworth Dr
Suite 100
Towson, MD 21204-2312

Mailing address

1300 W Sam Houston Pkwy S
Suite 300
Houston, TX 77042-2447
Phone (713) 297-7000

Other names 1

  • In Balance Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041117000899 MD Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2466416581 Receives reassigned benefits from 6 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Ellicott City, MD; Owings Mills, MD; Towson, MD

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

658 Kenilworth Dr
Ste 100
Towson, MD 21204
Phone (410) 296-4901

NPI Registry JSON

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

{
    "created_epoch": "1357516800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357516800000",
    "number": "1508103862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 W SAM HOUSTON PKWY S",
            "address_2": "SUITE 300",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770422447",
            "telephone_number": "713-297-7000",
            "fax_number": "713-297-7090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "658 KENILWORTH DR",
            "address_2": "SUITE 100",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212042312",
            "telephone_number": "410-339-4600",
            "fax_number": "410-339-4601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE FITNESS PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-07",
        "last_updated": "2013-01-07",
        "status": "A",
        "authorized_official_last_name": "BINSTEIN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "VP, AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "713-297-7000"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "In Balance Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Towson, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2013; 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.