Impact Sports Physical Therapy LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

25008 Issued in MD

Legal business name

IMPACT SPORTS PHYSICAL THERAPY LLC

Practice address

7468 Candlewood Rd
Hanover, MD 21076-3211

Phone

(410) 684-5642

NPI assigned

Aug 2, 2017

Organization subpart

No

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

Authorized official

Name

Robert Esbrandt, PT,DPT, PES

Title

Owner, Physical Therapist

Phone

(410) 322-9777

Specialties & licenses 1

Addresses

Other identifiers 4

Tax ID family

Impact Sports Physical Therapy LLC2 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.

• Impact Sports Physical Therapy LLC

  • Sports Physical Therapist
  • Forest Hill, MD
  • NPI 1467155499
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joshua Allen Plummer, PT, DPT

  • Physical Therapist
  • Hanover, MD
  • NPI 1780097113
  NPD
• Brittany Wentzel

  • Physical Therapist
  • Hanover, MD
  • NPI 1316552490
  NPD

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

{
    "created_epoch": "1501632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1660089600000",
    "number": "1770007411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8816 DOVE DR",
            "city": "PERRY HALL",
            "state": "MD",
            "postal_code": "211289000",
            "telephone_number": "410-322-9777",
            "fax_number": "443-632-0521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7468 CANDLEWOOD RD",
            "city": "HANOVER",
            "state": "MD",
            "postal_code": "210763211",
            "telephone_number": "410-684-5642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT SPORTS PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-08-02",
        "last_updated": "2022-08-10",
        "certification_date": "2022-08-10",
        "status": "A",
        "authorized_official_last_name": "ESBRANDT",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER, PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "410-322-9777",
        "authorized_official_credential": "PT,DPT, PES"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "25008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI ROBERT ESBRANDT",
            "identifier": "1013316884",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1780097113",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LLC ID #",
            "identifier": "W18167155",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARYLAND PT LICENSE",
            "identifier": "25008",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pamela Jean Hurley, AGACNP-BC
• Linda Michele Hurt, DPT
• Annette M Hyman, LCPC
• Carlson Igwacho, RN
• Immediate Home Health Care LLC
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• Charu Aggarwal Jain
• Jay's Place Residential Group Home
• Wen Ji
• Elijah Jones

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2022; 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.