NPIMap

Organization Active NPI

Ravenwood Rehabilitation Center LLC

  • Physical Therapist
  • Baltimore, MD
National Provider Identifier
1710920731
Registry record updated Sep 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
19589 AND 16840 Issued in MD
Legal business name
RAVENWOOD REHABILITATION CENTER LLC
Practice address
201 Milford Mill Rd
Suite 101
Baltimore, MD 21208-5903
Phone
(410) 415-0005
Fax
(410) 415-0006
NPI assigned
Jun 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2008

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

Authorized official

Name
Diana Pliner, PHYSICAL THERAPISTNPI 1497763601
Title
President
Phone
(410) 580-1320

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 19589 AND 16840 MD Primary

Addresses

Primary practice location

201 Milford Mill Rd
Suite 101
Baltimore, MD 21208-5903

Mailing address

201 Milford Mill Rd
Suite 101
Baltimore, MD 21208-5903
Phone (410) 415-0005

Other identifiers 2

IdentifierTypeStateIssuer
KCT9RAOtherMDBLUE CROSS,SHIELD GROUP#
510121200MedicaidMD

National Provider Directory

National Provider Directory

Locations

201 Milford Mill Rd
Ste 101
Baltimore, MD 21208
Phone (410) 415-0005

11 E Chestnut Hill Ln
Ste B
Reisterstown, MD 21136
Phone (410) 580-1320

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221091200000",
    "number": "1710920731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 MILFORD MILL RD",
            "address_2": "SUITE 101",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212085903",
            "telephone_number": "410-415-0005",
            "fax_number": "410-415-0006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 MILFORD MILL RD",
            "address_2": "SUITE 101",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212085903",
            "telephone_number": "410-415-0005",
            "fax_number": "410-415-0006"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAVENWOOD REHABILITATION CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2008-09-11",
        "status": "A",
        "authorized_official_last_name": "PLINER",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "410-580-1320",
        "authorized_official_credential": "PHYSICAL THERAPIST"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "19589 AND 16840",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS,SHIELD GROUP#",
            "identifier": "KCT9RA",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "510121200",
            "state": "MD"
        }
    ],
    "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 Sep 11, 2008; 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.