NPIMap

Organization Active NPI

Life Fitness Physical Therapy LLC

  • Physical Therapist
  • Baltimore, MD
National Provider Identifier
1548418932
Registry record updated May 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
LIFE FITNESS PHYSICAL THERAPY LLC
Practice address
9110 Philadelphia Rd Ste 104
Baltimore, MD 21237-4323
Phone
(410) 686-8922
Fax
(410) 686-8923
NPI assigned
Aug 28, 2008
Last updated
May 29, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
LIFE FITNESS PHYSICAL THERAPY LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 29, 2019

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

Authorized official

Name
Lawrance W McAfee
Title
Cfo
Phone
(713) 297-7000

Specialties & licenses 1

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

Addresses

Primary practice location

9110 Philadelphia Rd Ste 104
Baltimore, MD 21237-4323

Mailing address

1406B Crain Hwy S
Suite 107
Glen Burnie, MD 21061-4099
Phone (410) 590-2334

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
Part of
Life Fitness Phyl Thpy LLC

Locations

1406B Crain Hwy S
Ste 107
Glen Burnie, MD 21061
Phone (410) 590-2334

NPI Registry JSON

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

{
    "created_epoch": "1219881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559088000000",
    "number": "1548418932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1406B CRAIN HWY S",
            "address_2": "SUITE 107",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210614099",
            "telephone_number": "410-590-2334",
            "fax_number": "410-590-2336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9110 PHILADELPHIA RD STE 104",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212374323",
            "telephone_number": "410-686-8922",
            "fax_number": "410-686-8923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE FITNESS PHYSICAL THERAPY LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIFE FITNESS PHYSICAL THERAPY LLC",
        "enumeration_date": "2008-08-28",
        "last_updated": "2019-05-29",
        "status": "A",
        "authorized_official_last_name": "MCAFEE",
        "authorized_official_first_name": "LAWRANCE",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CFO",
        "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": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2019; 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.