Individual provider Active NPI

Stefanie P Ryan

  • Physical Therapist
  • Baltimore, MD
National Provider Identifier
1699091678
Registry record updated Nov 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
16190 Issued in MD
Practice address
2200 Kernan Dr
Baltimore, MD 21207-6665
Phone
(410) 448-6323
Fax
(410) 448-6338
NPI assigned
Apr 15, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 16190 MD Primary

Addresses

Primary practice location

2200 Kernan Dr
Baltimore, MD 21207-6665

Mailing address

2200 Kernan Dr
Baltimore, MD 21207-6665
Phone (410) 448-6323

Other practice location 1

844 Washington Rd Ste 101
Westminster, MD 21157-6664
Phone (410) 876-5600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200827002073 MD Practitioner - Physical Therapist in Private Practice 7719304310 Reassigns benefits to 1 organization
I20201204000071 DC Practitioner - Physical Therapist in Private Practice 7719304310 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maryland Sportscare and Rehab LLCGroup PAC ID 2860440427, 166 clinicians

Practice addresses (Care Compare)

25 Main St
Suite a
Reisterstown, MD 21136-1248
Phone (410) 833-8300

844 Washington Rd
Suite 101
Westminster, MD 21157-6664
Phone (410) 876-5600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16190MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Maryland Sportscare & Rehab LLC Physical Therapist CurrentSince Dec 1, 2020 Accepting new patients
Maryland Sportscare & Rehab, LLC Physical Therapist CurrentSince Dec 1, 2020 Accepting new patients
Fall Prevention and Stroke Rehab Physician, LLC PastSince Sep 1, 2024 Accepting new patients

Locations

9815 Main St
Ste 206
Damascus, MD 20872
Phone (301) 253-6761

17750 Creamery Rd
Ste B7
Emmitsburg, MD 21727
Phone (301) 447-1670

141 Thomas Johnson Dr
Ste 180
Frederick, MD 21702
Phone (301) 620-7478

2315 Hanover Pike
Ste G
Hampstead, MD 21074
Phone (410) 374-0925

25 Main St
Ste A
Reisterstown, MD 21136
Phone (410) 833-8300

417 E Baltimore St
Ste E
Taneytown, MD 21787
Phone (410) 514-2536

410 Meadow Creek Dr
Ste 106
Westminster, MD 21158
Phone (410) 861-5487

844 Washington Rd
Ste 101
Westminster, MD 21157

2200 Kernan Dr
Woodlawn, MD 21207
Phone (410) 448-2500

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1271289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606694400000",
    "number": "1699091678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 KERNAN DR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212076665",
            "telephone_number": "410-448-6323",
            "fax_number": "410-448-6338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 KERNAN DR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212076665",
            "telephone_number": "410-448-6323",
            "fax_number": "410-448-6338"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "844 Washington Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Westminster",
            "state": "MD",
            "postal_code": "211576664",
            "country_code": "US",
            "telephone_number": "410-876-5600",
            "fax_number": "410-876-1623",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RYAN",
        "first_name": "STEFANIE",
        "middle_name": "P",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-15",
        "last_updated": "2020-11-30",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "16190",
            "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 Nov 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.