Professional Sportscare, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PROFESSIONAL SPORTSCARE, LLC

Practice address

1404 S Main Chapel Way
Ste 104
Gambrills, MD 21054-1857

Phone

(410) 721-3377

Fax

(410) 721-3306

NPI assigned

Jan 18, 2016

Organization subpart

No

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

Authorized official

Name

Harris Thompson

Title

Ceo

Phone

(410) 885-6371

Specialties & licenses 1

Addresses

Other names 1

• PIVOT PHYSICAL THERAPY OF MARYLAND/GREATER BALTIMORE Doing business as

Tax ID family

Pivot Physical Therapy2 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.

• Professional Sportscare, LLC

  • Physical Therapist
  • Gambrills, MD
  • NPI 1841740321
  NPD tax ID

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

{
    "created_epoch": "1453075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453075200000",
    "number": "1760849038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7310 RITCHIE HWY",
            "address_2": "SUITE 500",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210613065",
            "telephone_number": "410-766-4047",
            "fax_number": "410-766-4049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 S MAIN CHAPEL WAY",
            "address_2": "STE 104",
            "city": "GAMBRILLS",
            "state": "MD",
            "postal_code": "210541857",
            "telephone_number": "410-721-3377",
            "fax_number": "410-721-3306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL SPORTSCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-18",
        "last_updated": "2016-01-18",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "HARRIS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "410-885-6371"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PIVOT PHYSICAL THERAPY OF MARYLAND/GREATER BALTIMORE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laray Imani Price, PH.D. - PSYCHOLOGIST
• Shamir Price, DPT
• Privia Medical Group, LLC
• Professional Sportscare & Rehab, LLC
• Professional Sportscare, LLC
• Professional Sportscare, LLC
• Project Chesapeake, LLC
• Project Chesapeake, LLC
• Melinda Randolph, PHARM.D.
• Vijiya S Rathod

• Physical Therapist in Gambrills, MD
• Providers in Gambrills, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2016; 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.