Greenhouse Wellness and Physical Therapy, Inc.

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

GREENHOUSE WELLNESS AND PHYSICAL THERAPY, INC.

Practice address

647B Blake Rd
Elkton, MD 21921-1805

Phone

(443) 877-9934

NPI assigned

Nov 16, 2021

Last updated

Dec 15, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kristin Pupa Jacono, DPT

Title

President/Physical Therapist

Phone

(908) 581-6642

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1637020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1639526400000",
    "number": "1740946516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 WALNUT LN",
            "city": "NORTH EAST",
            "state": "MD",
            "postal_code": "219016118",
            "telephone_number": "908-581-6642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "647B BLAKE RD",
            "city": "ELKTON",
            "state": "MD",
            "postal_code": "219211805",
            "telephone_number": "443-877-9934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREENHOUSE WELLNESS AND PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-16",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A",
        "authorized_official_last_name": "JACONO",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_middle_name": "PUPA",
        "authorized_official_title_or_position": "PRESIDENT/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "908-581-6642",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Angela Sue Grimes, LGPC
• Zhaohua Guan
• David Guiberson
• Kilah Renee Guns, ADT

• Physical Therapy Clinic/Center in Elkton, MD
• Providers in Elkton, MD by specialty
• Physical Therapy Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; 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.