NPIMap

Organization Active NPI

Sea Breeze Physical Therapy, LLC

  • Physical Therapist
  • Annapolis, MD
National Provider Identifier
1598129348
Registry record updated Jul 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
25856 Issued in MD
Legal business name
SEA BREEZE PHYSICAL THERAPY, LLC
Practice address
915 Bay Ridge Ave
Annapolis, MD 21403-3029
Phone
(703) 786-8827
NPI assigned
Apr 7, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2016

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

Authorized official

Name
Dr. Stacy Keith, DPT, PTNPI 1518910256
Title
Physical Therapist/Ceo
Phone
(703) 786-8827

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 25856 MD Primary

Addresses

Primary practice location

915 Bay Ridge Ave
Annapolis, MD 21403-3029

Mailing address

908 Boucher Ave
Annapolis, MD 21403-2302
Phone (703) 786-8827

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1459987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468281600000",
    "number": "1598129348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "908 BOUCHER AVE",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214032302",
            "telephone_number": "703-786-8827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 BAY RIDGE AVE",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214033029",
            "telephone_number": "703-786-8827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEA BREEZE PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-07",
        "last_updated": "2016-07-12",
        "status": "A",
        "authorized_official_last_name": "KEITH",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST/CEO",
        "authorized_official_telephone_number": "703-786-8827",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT, PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "25856",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2016; 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.