Organization Active NPI

Champions Performance Physical Therapy

  • Physical Therapy Clinic/Center
  • Lutherville Timonium, MD
National Provider Identifier
1720787146
Registry record updated Feb 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
CHAMPIONS PERFORMANCE PHYSICAL THERAPY
Practice address
29 Greenmeadow Dr
Lutherville Timonium, MD 21093-3256
Phone
(240) 446-2591
NPI assigned
Feb 24, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2023

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

Authorized official

Name
Dr. Zachary S Mitchell, DPTNPI 1750862835
Title
Owner
Phone
(240) 446-2591

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 Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

29 Greenmeadow Dr
Lutherville Timonium, MD 21093-3256

Mailing address

9 Northwood Dr
Timonium, MD 21093-4217

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230613002747 MD Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5597122176 Receives reassigned benefits from 1 practitioner
Practice locations: Lutherville Timonium, MD

National Provider Directory

National Provider Directory

Locations

29 Greenmeadow Dr
Timonium, MD 21093
Phone (240) 446-2591

Practitioners & affiliated clinicians

Practitioners 1

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": "1677196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677196800000",
    "number": "1720787146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 NORTHWOOD DR",
            "city": "TIMONIUM",
            "state": "MD",
            "postal_code": "210934217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 GREENMEADOW DR",
            "city": "LUTHERVILLE TIMONIUM",
            "state": "MD",
            "postal_code": "210933256",
            "telephone_number": "240-446-2591"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAMPIONS PERFORMANCE PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-24",
        "last_updated": "2023-02-24",
        "certification_date": "2023-02-23",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "ZACHARY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "240-446-2591",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutherville Timonium, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.