Physical and Sports Rehab Consultants, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

21076 Issued in MD

Legal business name

PHYSICAL AND SPORTS REHAB CONSULTANTS, LLC

Practice address

2520 Moores Plains Blvd
Upper Marlboro, MD 20774-8027

Phone

(301) 802-3690

Fax

(301) 627-1191

NPI assigned

Dec 7, 2010

Last updated

Dec 7, 2010By 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

Mr. Paul A Heath, PT

Title

Ceo/ Executive Director

Phone

(301) 802-3690

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1291680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291680000000",
    "number": "1639472095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 MOORES PLAINS BLVD",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207748027",
            "telephone_number": "301-802-3690",
            "fax_number": "301-627-1191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 MOORES PLAINS BLVD",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207748027",
            "telephone_number": "301-802-3690",
            "fax_number": "301-627-1191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL AND SPORTS REHAB CONSULTANTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-07",
        "last_updated": "2010-12-07",
        "status": "A",
        "authorized_official_last_name": "HEATH",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO/ EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "301-802-3690",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MD",
            "license": "21076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• PGN Dental LLC (Elegant Smiles Dentistry)
• Susan Marie Phelps, CRNP
• Nwabu Phendulu, LGPC
• Granada Phillips
• Phoenix Pediatric Therapy Services, LLC
• Tyreis D Pierce, LCSW-C
• Nwoleza Pierre
• Jay Pimble
• Kendra Plummer
• Nana Pobee, REGISTERED NURSE

• Physical Therapy Clinic/Center in Upper Marlboro, MD
• Providers in Upper Marlboro, 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 Dec 7, 2010; 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.