NPIMap

Organization Active NPI

Physiocare Rehab & Wellness, LLC

  • Physical Therapy Clinic/Center
  • Brandywine, MD
National Provider Identifier
1730564394
Registry record updated Apr 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
22667 Issued in MD
Legal business name
PHYSIOCARE REHAB & WELLNESS, LLC
Practice address
7651 Matapeake Business Dr Ste 203
Brandywine, MD 20613-3038
Phone
(443) 583-4180
NPI assigned
Jul 24, 2015
Last updated
Apr 12, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2023

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

Authorized official

Name
Dr. Kwabena Ofori-Ansah, DPTNPI 1992933733
Title
President/Ceo
Phone
(240) 460-0960

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 22667 MD Primary

Addresses

Primary practice location

7651 Matapeake Business Dr Ste 203
Brandywine, MD 20613-3038

Mailing address

7651 Matapeake Business Dr # 203
Brandywine, MD 20613-3038
Phone (301) 782-4600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151103000241 DC Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2567772627 Receives reassigned benefits from 6 practitioners
Practice locations: Brandywine, MD; Lanham, MD

National Provider Directory

National Provider Directory
Tax ID family
Physiocare Rehab and Wellness2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

10631 Greenbelt Rd
Ste 303
Lanham, MD 20706
Phone (301) 383-2406

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1437696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681257600000",
    "number": "1730564394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7651 MATAPEAKE BUSINESS DR # 203",
            "city": "BRANDYWINE",
            "state": "MD",
            "postal_code": "206133038",
            "telephone_number": "301-782-4600",
            "fax_number": "301-782-4601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7651 MATAPEAKE BUSINESS DR STE 203",
            "city": "BRANDYWINE",
            "state": "MD",
            "postal_code": "206133038",
            "telephone_number": "443-583-4180"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSIOCARE REHAB & WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-24",
        "last_updated": "2023-04-12",
        "certification_date": "2023-04-12",
        "status": "A",
        "authorized_official_last_name": "OFORI-ANSAH",
        "authorized_official_first_name": "KWABENA",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "240-460-0960",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MD",
            "license": "22667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandywine, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 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.