Kaymon Physical Therapy and Associates

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

23062 Issued in MD

Legal business name

KAYMON PHYSICAL THERAPY AND ASSOCIATES

Practice address

9201 Edgeworth Dr
#4251
Capitol Heights, MD 20791-7501

Phone

(240) 245-0476

Fax

(202) 204-5637

NPI assigned

Mar 18, 2016

Organization subpart

No

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

Authorized official

Name

Ms. Earlene D. Jackson, PT, DPT

Title

President/ Ceo

Phone

(240) 245-0476

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1458259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460592000000",
    "number": "1669833661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9201 EDGEWORTH DR",
            "address_2": "#4251",
            "city": "CAPITOL HEIGHTS",
            "state": "MD",
            "postal_code": "207917501",
            "telephone_number": "240-245-0476",
            "fax_number": "202-204-5637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9201 EDGEWORTH DR",
            "address_2": "#4251",
            "city": "CAPITOL HEIGHTS",
            "state": "MD",
            "postal_code": "207917501",
            "telephone_number": "240-245-0476",
            "fax_number": "202-204-5637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KAYMON PHYSICAL THERAPY AND ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-18",
        "last_updated": "2016-04-14",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "EARLENE",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT/ CEO",
        "authorized_official_telephone_number": "240-245-0476",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MD",
            "license": "23062",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Providers in Capitol Heights, MD by specialty
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.