In Balance Physical Therapy and Wellness Center LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

19223 Issued in MD

Legal business name

IN BALANCE PHYSICAL THERAPY AND WELLNESS CENTER LLC

Practice address

3455 Wilkens Ave
Suite 200
Baltimore, MD 21229-5213

Phone

(443) 948-6609

Fax

(443) 948-6610

NPI assigned

Mar 7, 2016

Organization subpart

No

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

Authorized official

Name

Mrs. Jodi Samara Berger, PT

Title

President

Phone

(443) 948-6609

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

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

• In Balance Physical Therapy and Wellness Center LLC

  • Physical Therapist
  • Owings Mills, MD
  • NPI 1588890065

  O20090810000523

  Same enrollment

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kerry Kress, P.T.

  • Physical Therapist
  • Towson, MD
  • NPI 1780824961
  NPD
• Aleksandra Polyanskaya

  • Occupational Therapist
  • Owings Mills, MD
  • NPI 1760127575
  NPD
• Shayna L Roberts, P.T.

  • Physical Therapist
  • Baltimore, MD
  • NPI 1124148051
  NPD
• Jay Gerstenblith, M.D.

  • Pulmonary Disease Physician
  • Baltimore, MD
  • NPI 1750346409
  NPD (past)

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

{
    "created_epoch": "1457308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465257600000",
    "number": "1558722397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3455 WILKENS AVE",
            "address_2": "SUITE 200",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212295213",
            "telephone_number": "443-948-6609",
            "fax_number": "443-948-6610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3455 WILKENS AVE",
            "address_2": "SUITE 200",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212295213",
            "telephone_number": "443-948-6609",
            "fax_number": "443-948-6610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IN BALANCE PHYSICAL THERAPY AND WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-07",
        "last_updated": "2016-06-07",
        "status": "A",
        "authorized_official_last_name": "BERGER",
        "authorized_official_first_name": "JODI",
        "authorized_official_middle_name": "SAMARA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "443-948-6609",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MD",
            "license": "19223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Physical Therapy Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2016; 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.