NPIMap

Organization Active NPI

Maryland Sportscare & Rehab, LLC

Doing business as Pivot Physical Therapy

  • Physical Therapist
  • Glen Burnie, MD
National Provider Identifier
1528517307
Registry record updated Nov 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
MARYLAND SPORTSCARE & REHAB, LLC
Doing business as
Pivot Physical Therapy
Practice address
1600 Crain Hwy S
302
Glen Burnie, MD 21061-5577
Phone
(410) 768-1213
NPI assigned
Sep 22, 2016
Last updated
Nov 1, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2024

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

Authorized official

Name
Tasheda Broughton, PESC
Title
Manager, Credentialing
Phone
(252) 248-3313

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

1600 Crain Hwy S
302
Glen Burnie, MD 21061-5577

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (252) 248-3313

Other names 1

  • PIVOT PHYSICAL THERAPY Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Maryland Sportscare Rehab LLC72 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1600 Crain Hwy S
Ste 302
Glen Burnie, MD 21061
Phone (410) 766-4435

NPI Registry JSON

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

{
    "created_epoch": "1474502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730419200000",
    "number": "1528517307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "252-248-3313",
            "fax_number": "410-648-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 CRAIN HWY S",
            "address_2": "302",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210615577",
            "telephone_number": "410-768-1213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND SPORTSCARE & REHAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-22",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A",
        "authorized_official_last_name": "BROUGHTON",
        "authorized_official_first_name": "TASHEDA",
        "authorized_official_title_or_position": "MANAGER, CREDENTIALING",
        "authorized_official_telephone_number": "252-248-3313",
        "authorized_official_credential": "PESC"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PIVOT PHYSICAL THERAPY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PIVOT PHYSICAL THERAPY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Glen Burnie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2024; 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.