Organization Active NPI

Somerset PT

  • Physical Therapy Clinic/Center
  • Princess Anne, MD
National Provider Identifier
1679103741
Registry record updated Mar 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
SOMERSET PT
Practice address
10840 Market LN Ste 2
Princess Anne, MD 21853-3072
Phone
(443) 888-6105
Fax
(443) 888-6107
NPI assigned
Jan 17, 2020
Last updated
Mar 19, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2020

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

Authorized official

Name
Shawn M Thomas
Title
Manager
Phone
(443) 888-6105

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NU Primary

Addresses

Primary practice location

10840 Market LN Ste 2
Princess Anne, MD 21853-3072

Mailing address

10840 Market LN Ste 2
Princess Anne, MD 21853-3072
Phone (443) 888-6105

Other practice location 1

12302 Somerset Ave
Princess Anne, MD 21853-3099
Phone (443) 888-6105

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200324000025 MD Part B Supplier - Clinic/Group Practice 3678901709 Receives reassigned benefits from 2 practitioners
Practice locations: Princess Anne, MD

National Provider Directory

National Provider Directory

Locations

10840 Market Ln
Ste 2
Princess Anne, MD 21853
Phone (443) 888-6105

12302 Somerset Ave
Princess Anne, MD 21853
Phone (410) 651-0300

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1579219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584576000000",
    "number": "1679103741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10840 MARKET LN STE 2",
            "city": "PRINCESS ANNE",
            "state": "MD",
            "postal_code": "218533072",
            "telephone_number": "443-888-6105",
            "fax_number": "443-888-6107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10840 MARKET LN STE 2",
            "city": "PRINCESS ANNE",
            "state": "MD",
            "postal_code": "218533072",
            "telephone_number": "443-888-6105",
            "fax_number": "443-888-6107"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12302 Somerset Ave",
            "address_purpose": "LOCATION",
            "city": "Princess Anne",
            "state": "MD",
            "postal_code": "218533099",
            "country_code": "US",
            "telephone_number": "443-888-6105",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOMERSET PT",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-17",
        "last_updated": "2020-03-19",
        "certification_date": "2020-03-19",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "443-888-6105"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princess Anne, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2020; 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.