NPIMap

Organization Active NPI

Riderwood Village, Inc.

  • Rehabilitation Clinic/Center
  • Silver Spring, MD
National Provider Identifier
1679520662
Registry record updated Jun 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
RIDERWOOD VILLAGE, INC.
Practice address
3120 Gracefield Road
Attn: Rehabilitation Manager
Silver Spring, MD 20904-5810
Phone
(301) 572-1300
Fax
(410) 204-7237
NPI assigned
May 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2012

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

Authorized official

Name
James K Walter
Title
Finance Director
Phone
(410) 402-2315

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

3120 Gracefield Road
Attn: Rehabilitation Manager
Silver Spring, MD 20904-5810

Mailing address

3140 Gracefield Road
Attn: Executive Director
Silver Spring, MD 20904-1820
Phone (301) 572-1300

Other names 1

  • Outpatient Rehabilitation Agency at Riderwood Village Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040428000777 MD Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 4183611437 Practice locations: Silver Spring, MD

Outpatient physical therapy / speech pathology certification: CCN 216671

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
RIDERWOOD VILLAGE OUTPATIENT REHABILITATION AGENCY
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Dec 12, 2002
Last certification
Mar 7, 2025
Ownership / control type
Proprietary
Facility address
3120 Gracefield Rd
Silver Spring, MD 20904

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Outpatient Rehabilitation Agency at Riderwood Village4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340150400000",
    "number": "1679520662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3140 GRACEFIELD ROAD",
            "address_2": "ATTN: EXECUTIVE DIRECTOR",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209041820",
            "telephone_number": "301-572-1300",
            "fax_number": "410-204-7237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3120 GRACEFIELD ROAD",
            "address_2": "ATTN: REHABILITATION MANAGER",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209045810",
            "telephone_number": "301-572-1300",
            "fax_number": "410-204-7237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIDERWOOD VILLAGE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2012-06-20",
        "status": "A",
        "authorized_official_last_name": "WALTER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "FINANCE DIRECTOR",
        "authorized_official_telephone_number": "410-402-2315"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Outpatient Rehabilitation Agency at Riderwood Village",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Silver Spring, MD

Sources for this page

Verify at the official NPI Registry.