Active NPI
Jeanne Sandvick, PTA
- Physical Therapy Assistant
- Baltimore, MD
National Provider Identifier
1679984538
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- A1207
- Practice address
- 5601 Loch Raven Blvd
O'Neill 2
Baltimore, MD 21239-2945 - Phone
- (443) 444-4600
- Fax
- (443) 444-4607
- NPI assigned
- May 14, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | A1207 | MD | Primary |
Addresses
Primary practice location
5601 Loch Raven Blvd
O'Neill 2
Baltimore, MD 21239-2945
Mailing address
5445 Loch Raven Blvd Ste 403a
Baltimore, MD 21239-2943
Phone (443) 444-4600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A1207 | MD | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1708560000000",
"number": "1679984538",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5445 LOCH RAVEN BLVD STE 403A",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212392943",
"telephone_number": "443-444-4600",
"fax_number": "443-444-5757"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5601 LOCH RAVEN BLVD",
"address_2": "O'NEILL 2",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212392945",
"telephone_number": "443-444-4600",
"fax_number": "443-444-4607"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANDVICK",
"first_name": "JEANNE",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-05-14",
"last_updated": "2024-02-22",
"certification_date": "2024-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MD",
"license": "A1207",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.