Organization Active NPI

Patterson Physical Therapy Inc

  • Physical Therapist
  • Severna Park, MD
National Provider Identifier
1750311908
Registry record updated Oct 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
16229 Issued in MD
Legal business name
PATTERSON PHYSICAL THERAPY INC
Practice address
650 Ritchie Hwy
Suite 103
Severna Park, MD 21146-3916
Phone
(410) 647-1961
Fax
(410) 647-8276
NPI assigned
Jul 4, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2014

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

Authorized official

Name
Mrs. Elizabeth Patterson, P.T.NPI 1386614972
Title
Physical Therapist
Phone
(410) 647-1961

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X 16229 MD Primary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X 16203 MD

Addresses

Primary practice location

650 Ritchie Hwy
Suite 103
Severna Park, MD 21146-3916

Mailing address

650 Ritchie Hwy
Suite 103
Severna Park, MD 21146-3916
Phone (410) 647-1961

Other identifiers 6

IdentifierTypeStateIssuer
N126-0003OtherBCBS
89575801OtherMDCAREFIRST
52908331OtherMDCAREFIRST
N126-0001OtherMDBCBS
52100440OtherMDCAREFIRST
N126-0002OtherMDBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060725000396 MD Part B Supplier - Clinic/Group Practice 8527071232 Receives reassigned benefits from 3 practitioners
Practice locations: Severna Park, MD

National Provider Directory

National Provider Directory

Locations

650 Ritchie Hwy
Ste 103
Severna Park, MD 21146
Phone (410) 647-1961

Practitioners & affiliated clinicians

Practitioners 8

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": "1151971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414713600000",
    "number": "1750311908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 RITCHIE HWY",
            "address_2": "SUITE 103",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211463916",
            "telephone_number": "410-647-1961",
            "fax_number": "410-647-8276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 RITCHIE HWY",
            "address_2": "SUITE 103",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211463916",
            "telephone_number": "410-647-1961",
            "fax_number": "410-647-8276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATTERSON PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-04",
        "last_updated": "2014-10-31",
        "status": "A",
        "authorized_official_last_name": "PATTERSON",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "410-647-1961",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "16229",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "16203",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "N126-0003",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "89575801",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "52908331",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "N126-0001",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST",
            "identifier": "52100440",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "N126-0002",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Severna Park, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2014; 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.