NPIMap

Organization Active NPI

Sovereignty Health Services LLC

  • Physical Therapy Clinic/Center
  • Randallstown, MD
National Provider Identifier
1629699293
Registry record updated May 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
SOVEREIGNTY HEALTH SERVICES LLC
Practice address
5310 Old Court Rd
Randallstown, MD 21133-5243
Phone
(410) 940-1983
NPI assigned
May 5, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2024

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

Authorized official

Name
Kehinde TijaniNPI 1194206102
Title
Otr/L
Phone
(410) 940-1983

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

5310 Old Court Rd
Randallstown, MD 21133-5243

Mailing address

152 Spectator LN
Owings Mills, MD 21117-4444
Phone (410) 940-1983

Other practice location 1

1319 Woodbridge Station Way Ste 102
Edgewood, MD 21040-3852
Phone (410) 940-1983

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1588636800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716940800000",
    "number": "1629699293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 SPECTATOR LN",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211174444",
            "telephone_number": "410-940-1983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5310 OLD COURT RD",
            "city": "RANDALLSTOWN",
            "state": "MD",
            "postal_code": "211335243",
            "telephone_number": "410-940-1983"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1319 Woodbridge Station Way Ste 102",
            "address_purpose": "LOCATION",
            "city": "Edgewood",
            "state": "MD",
            "postal_code": "210403852",
            "country_code": "US",
            "telephone_number": "410-940-1983",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOVEREIGNTY HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-05-05",
        "last_updated": "2024-05-29",
        "certification_date": "2024-05-29",
        "status": "A",
        "authorized_official_last_name": "TIJANI",
        "authorized_official_first_name": "KEHINDE",
        "authorized_official_title_or_position": "OTR/L",
        "authorized_official_telephone_number": "410-940-1983"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Randallstown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; 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.