NPIMap

Organization Active NPI

Five Star Rehabilitation and Wellness Services, LLC.

Doing business as Ageility Physical Therapy Solutions at Ellicott City

  • Physical Therapy Clinic/Center
  • Ellicott City, MD
National Provider Identifier
1578576906
Registry record updated Oct 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
FIVE STAR REHABILITATION AND WELLNESS SERVICES, LLC.
Doing business as
Ageility Physical Therapy Solutions at Ellicott City
Practice address
3004 North Ridge Road
Ellicott City, MD 21043-3381
Phone
(410) 480-2175
Fax
(410) 750-1240
NPI assigned
Aug 15, 2006
Last updated
Oct 18, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
FIVE STAR REHABILITATION AND WELLNESS SERVICES, LLC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 18, 2022

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

Authorized official

Name
Jeffrey C Leer
Title
President & Chief Executive Officer
Phone
(617) 796-8387

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

3004 North Ridge Road
Ellicott City, MD 21043-3381

Mailing address

255 Washington St Ste 230
Newton, MA 02458-1644
Phone (617) 796-8387

Other names 1

  • Ageility Physical Therapy Solutions at Ellicott City Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Alerislife Inc3 organizations share this tax ID, including this one
Part of
Five Star Rehabilitation and Wellness Services LLC

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666051200000",
    "number": "1578576906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 WASHINGTON ST STE 230",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024581644",
            "telephone_number": "617-796-8387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3004 NORTH RIDGE ROAD",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210433381",
            "telephone_number": "410-480-2175",
            "fax_number": "410-750-1240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIVE STAR REHABILITATION AND WELLNESS SERVICES, LLC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FIVE STAR REHABILITATION AND WELLNESS SERVICES, LLC.",
        "enumeration_date": "2006-08-15",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A",
        "authorized_official_last_name": "LEER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT & CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "617-796-8387"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ageility Physical Therapy Solutions at Ellicott City",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; 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.