Active NPI
Julian Ezekiel Vesnovsky, DPT
- Physical Therapist
- Glen Burnie, MD
National Provider Identifier
1528559267
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 26971
- Practice address
- 1600 Crain Hwy S Ste 402
Glen Burnie, MD 21061-6437 - Phone
- (410) 590-0700
- NPI assigned
- May 29, 2018
- 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 Therapist | 225100000X | 26971 | MD | Primary |
Addresses
Primary practice location
1600 Crain Hwy S Ste 402
Glen Burnie, MD 21061-6437
Mailing address
1600 Crain Hwy S
Glen Burnie, MD 21061-5577
Phone (410) 590-0700
Other practice location 1
1515 Merritt Blvd
Dundalk, MD 21222-2113
Phone (410) 285-0920
Other practice location 2
1836 Greene Tree Rd
Baltimore, MD 21208-1381
Phone (443) 304-7329
Other practice location 3
8615 Ridgelys Choice Dr Ste 104
Nottingham, MD 21236-3027
Phone (410) 529-3913
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)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527552000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601337600000",
"number": "1528559267",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 CRAIN HWY S",
"city": "GLEN BURNIE",
"state": "MD",
"postal_code": "210615577",
"telephone_number": "410-590-0700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 CRAIN HWY S STE 402",
"city": "GLEN BURNIE",
"state": "MD",
"postal_code": "210616437",
"telephone_number": "410-590-0700"
}
],
"practiceLocations": [
{
"address_1": "1515 Merritt Blvd",
"address_purpose": "LOCATION",
"city": "Dundalk",
"state": "MD",
"postal_code": "212222113",
"country_code": "US",
"telephone_number": "410-285-0920",
"fax_number": "410-313-8314",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1836 Greene Tree Rd",
"address_purpose": "LOCATION",
"city": "Baltimore",
"state": "MD",
"postal_code": "212081381",
"country_code": "US",
"telephone_number": "443-304-7329",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "8615 Ridgelys Choice Dr Ste 104",
"address_purpose": "LOCATION",
"city": "Nottingham",
"state": "MD",
"postal_code": "212363027",
"country_code": "US",
"telephone_number": "410-529-3913",
"fax_number": "410-313-8314",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VESNOVSKY",
"first_name": "JULIAN",
"middle_name": "EZEKIEL",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-05-29",
"last_updated": "2020-09-29",
"certification_date": "2020-09-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "26971",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Sep 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.