Individual provider Active NPI

Jesse Corine North, PT, DPT

  • Physical Therapist
  • Sparks Glencoe, MD
National Provider Identifier
1720752801
Registry record updated Feb 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
28993 Issued in MD
Practice address
954 Ridgebrook Rd Ste 330
Sparks Glencoe, MD 21152-9440
Phone
(443) 212-5745
Fax
(443) 212-5749
NPI assigned
Aug 3, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT029721 PA
Physical Therapist 225100000X
Physical Therapist 225100000X PT029701 PA
Physical Therapist 225100000X 28993 MD Primary

Addresses

Primary practice location

954 Ridgebrook Rd Ste 330
Sparks Glencoe, MD 21152-9440

Mailing address

954 Ridgebrook Rd Ste 330
Sparks Glencoe, MD 21152-9440
Phone (443) 212-5745

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20210817002712 PA Practitioner - Physical Therapist in Private Practice 9537564356 Reassigns benefits to 1 organization
I20230307001857 MD Practitioner - Physical Therapist in Private Practice 9537564356 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
28993MDMDClinical Social Worker
PT029701PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sparks Physical Therapy, Inc. Physical Therapist CurrentSince Jan 30, 2023 Accepting new patients
Revolution Wellness and Physical Therapy LLC Physical Therapist Current Accepting new patients
Sparks Physical Therapy, Inc. Physical Therapist CurrentSince Oct 13, 2024 Accepting new patients
Drayer Physical Therapy Institute LLC Physical Therapist CurrentSince Aug 6, 2021 Accepting new patients
Drayer Physical Therapy Institute LLC Physical Therapist Current Accepting new patients
Drayer Physical Therapy Institute LLC Physical Therapist CurrentSince Aug 6, 2021 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

954 Ridgebrook Rd
Ste 330
Sparks Glencoe, MD 21152
Phone (301) 792-1450

954 Ridgebrook Rd
Ste 310
Sparks Glencoe, MD 21152
Phone (443) 212-5745

781 Far Hills Dr
Ste 400
New Freedom, PA 17349
Phone (717) 235-9890

492 N Main St
Red Lion, PA 17356
Phone (717) 417-5606

Organizations & group practices 6

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": "1627948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1720752801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "954 RIDGEBROOK RD STE 330",
            "city": "SPARKS GLENCOE",
            "state": "MD",
            "postal_code": "211529440",
            "telephone_number": "443-212-5745",
            "fax_number": "443-212-5749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "954 RIDGEBROOK RD STE 330",
            "city": "SPARKS GLENCOE",
            "state": "MD",
            "postal_code": "211529440",
            "telephone_number": "443-212-5745",
            "fax_number": "443-212-5749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NORTH",
        "first_name": "JESSE",
        "middle_name": "CORINE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-03",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT029721",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT029701",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "28993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparks Glencoe, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.