NPIMap

Organization Active NPI

Shore Therapy Solutions, LLC

  • Physical Therapy Clinic/Center
  • Berlin, MD
National Provider Identifier
1649932104
Registry record updated Oct 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
SHORE THERAPY SOLUTIONS, LLC
Practice address
11810 Man O War LN
Berlin, MD 21811-3362
Phone
(410) 216-4579
NPI assigned
Oct 12, 2021
Last updated
Oct 12, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2021

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

Authorized official

Name
Dr. Lisa Marie Clifford, PT DPTNPI 1669805156
Title
Owner/Clinic Director
Phone
(410) 216-4579

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 Therapy Clinic/Center 261QP2000X NU Primary

Addresses

Primary practice location

11810 Man O War LN
Berlin, MD 21811-3362

Mailing address

PO Box 1927
Berlin, MD 21811-5927
Phone (410) 216-4579

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lisa@shoretherapysolutions.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DE2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20211025002065 MD Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8820486848 Receives reassigned benefits from 9 practitioners
Practice locations: Berlin, MD
O20220128000147 DE Part B Supplier - Physical/Occupational Therapy Group in Private Practice 8820486848 Receives reassigned benefits from 1 practitioner
Practice locations: Dagsboro, DE

National Provider Directory

National Provider Directory

Locations

29 Broad St
Ste 206
Berlin, MD 21811
Phone (443) 228-6040

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1633996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633996800000",
    "number": "1649932104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1927",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218115927",
            "telephone_number": "410-216-4579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11810 MAN O WAR LN",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218113362",
            "telephone_number": "410-216-4579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORE THERAPY SOLUTIONS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-12",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A",
        "authorized_official_last_name": "CLIFFORD",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER/CLINIC DIRECTOR",
        "authorized_official_telephone_number": "410-216-4579",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lisa@shoretherapysolutions.com",
            "affiliation": "N",
            "endpointDescription": "Business Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "11810 Man O War Ln",
            "city": "Berlin",
            "state": "MD",
            "country_code": "US",
            "postal_code": "218113362",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Berlin, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2021; 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.