NPIMap

Organization Active NPI

Calvert Physical Therapy and Sports Fitness Ctr.

  • Physical Therapist
  • Prince Frederick, MD
National Provider Identifier
1780724617
Registry record updated Oct 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
CALVERT PHYSICAL THERAPY AND SPORTS FITNESS CTR.
Practice address
130 Hospital Rd
Suite 103
Prince Frederick, MD 20678
Phone
(410) 535-8180
Fax
(410) 535-8325
NPI assigned
Feb 8, 2007
Last updated
Oct 6, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2009

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

Authorized official

Name
Mrs. Deborah J Smootz
Title
Manager
Phone
(410) 414-4846

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 15757 MD
Comprehensive Outpatient Rehabilitation Facility (CORF) 261QR0401X
Physical Therapist 225100000X Primary
Occupational Therapist 225X00000X

Addresses

Primary practice location

130 Hospital Rd
Suite 103
Prince Frederick, MD 20678

Mailing address

130 Hospital Rd
Suite 103
Prince Frederick, MD 20678-4022
Phone (410) 535-8180

Other identifiers 1

IdentifierTypeStateIssuer
406409700MedicaidMD

National Provider Directory

National Provider Directory

Locations

120 Hospital Rd
#100
Prnc Frederck, MD 20678
Phone (410) 257-7106

Practitioners & affiliated clinicians

Practitioners 29

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.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254787200000",
    "number": "1780724617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 HOSPITAL RD",
            "address_2": "SUITE 103",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "206784022",
            "telephone_number": "410-535-8180",
            "fax_number": "410-535-8325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 HOSPITAL RD",
            "address_2": "SUITE 103",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "20678",
            "telephone_number": "410-535-8180",
            "fax_number": "410-535-8325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALVERT PHYSICAL THERAPY AND SPORTS FITNESS CTR.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2009-10-06",
        "status": "A",
        "authorized_official_last_name": "SMOOTZ",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "410-414-4846",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MD",
            "license": "15757",
            "primary": false
        },
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "406409700",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Prince Frederick, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2009; 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.