Maryland Real Life Designs, LLC

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

MARYLAND REAL LIFE DESIGNS, LLC

Doing business as

Real Life Prosthetics

Practice address

932 Washington Ave
Chestertown, MD 21620-3324

Phone

(410) 810-1370

NPI assigned

Sep 21, 2010

Last updated

Jan 11, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sandra Yeater

Title

Member/Cfo

Phone

(410) 569-0606

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Real Life Prosthetics Doing business as

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Maryland Real Life Designs, LLC

  • Prosthetic/Orthotic Supplier
  • Abingdon, MD
  • NPI 1124028535

  1355453259

  Same PAC ID
• Maryland Real Life Designs, LLC

  dba Real Life Prosthetics

  • Prosthetic/Orthotic Supplier
  • Towson, MD
  • NPI 1144538497

  1355453259

  Same PAC ID
• Maryland Real Life Designs, LLC

  dba Real Life Prosthetics

  • Prosthetic/Orthotic Supplier
  • Wilmington, DE
  • NPI 1295485365

  1355453259

  Same PAC ID
• Maryland Real Life Designs, LLC

  dba Real Life Prosthetics

  • Prosthetic/Orthotic Supplier
  • Newark, DE
  • NPI 1912216557

  1355453259

  Same PAC ID

Tax ID family

Maryland Real Life Designs LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

• Maryland Real Life Designs, LLC

  • Prosthetic/Orthotic Supplier
  • Abingdon, MD
  • NPI 1124028535
  NPD tax ID
• Maryland Real Life Designs, LLC

  dba Real Life Prosthetics

  • Prosthetic/Orthotic Supplier
  • Wilmington, DE
  • NPI 1295485365
  NPD tax ID
• Maryland Real Life Designs, LLC

  dba Real Life Prosthetics

  • Prosthetic/Orthotic Supplier
  • Newark, DE
  • NPI 1861726424
  NPD tax ID
• Maryland Real Life Designs, LLC

  dba Real Life Prosthetics

  • Prosthetic/Orthotic Supplier
  • Newark, DE
  • NPI 1912216557
  NPD tax ID

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

{
    "created_epoch": "1285027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641859200000",
    "number": "1609184951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3435 BOX HILL CORPORATE CENTER DR",
            "address_2": "SUITE D",
            "city": "ABINGDON",
            "state": "MD",
            "postal_code": "210091204",
            "telephone_number": "410-569-0606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "932 WASHINGTON AVE",
            "city": "CHESTERTOWN",
            "state": "MD",
            "postal_code": "216203324",
            "telephone_number": "410-810-1370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND REAL LIFE DESIGNS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-21",
        "last_updated": "2022-01-11",
        "certification_date": "2022-01-11",
        "status": "A",
        "authorized_official_last_name": "YEATER",
        "authorized_official_first_name": "SANDRA",
        "authorized_official_title_or_position": "MEMBER/CFO",
        "authorized_official_telephone_number": "410-569-0606"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01110310001",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Real Life Prosthetics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica Marsh
• Malorie Martinez, M.A., CCC-SLP
• Lisa M Marx, NP
• Maryland General Clinical Practice Group, Inc.
• Maryland Imaging Network PC
• Jacqueline A. Mathwich, P.T.
• Michelle Matthews, LCSW-C
• Abby Mae McCormick, LCSW-C
• Susan McDonald, PTA
• Mary Lynne McDougle, CRNA

• Prosthetic/Orthotic Supplier in Chestertown, MD
• Providers in Chestertown, MD by specialty
• Prosthetic/Orthotic Supplier in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2022; 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.