NPIMap

Organization Active NPI

Renew-Rebuild-Rehabilitate Chiropractic Center, LLC

  • Chiropractor
  • Baltimore, MD
National Provider Identifier
1700219656
Registry record updated Aug 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
S01679 Issued in MD
Legal business name
RENEW-REBUILD-REHABILITATE CHIROPRACTIC CENTER, LLC
Practice address
312 Martin Luther King Jr Blvd
Suite 100
Baltimore, MD 21201-1221
Phone
(410) 366-3250
NPI assigned
Aug 14, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2013

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

Authorized official

Name
Dr. Sue Ellen Podmijersky, D.C.
Title
Owner
Phone
(410) 366-3250

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X S01679 MD Primary

Addresses

Primary practice location

312 Martin Luther King Jr Blvd
Suite 100
Baltimore, MD 21201-1221

Mailing address

PO Box 5001
Severna Park, MD 21146-0360
Phone (410) 366-3250

National Provider Directory

National Provider Directory

Locations

312 Martin Luther King Jr Blvd
Ste 100
Baltimore, MD 21201
Phone (410) 366-3250

NPI Registry JSON

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

{
    "created_epoch": "1376438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376438400000",
    "number": "1700219656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5001",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211460360",
            "telephone_number": "410-366-3250",
            "fax_number": "410-366-3252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 MARTIN LUTHER KING JR BLVD",
            "address_2": "SUITE 100",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212011221",
            "telephone_number": "410-366-3250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEW-REBUILD-REHABILITATE CHIROPRACTIC CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-14",
        "last_updated": "2013-08-14",
        "status": "A",
        "authorized_official_last_name": "PODMIJERSKY",
        "authorized_official_first_name": "SUE ELLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-366-3250",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "S01679",
            "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 Aug 14, 2013; 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.