K Conway Physical Therapy, Inc.

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

17145 Issued in MD

Legal business name

K CONWAY PHYSICAL THERAPY, INC.

Practice address

110 Main Street
Prince Frederick, MD 20678

Phone

(410) 610-4926

NPI assigned

Jun 18, 2007

Organization subpart

No

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

Authorized official

Name

Kirk Conway, PTNPI 1578645933

Title

Owner

Phone

(410) 610-4926

Specialties & licenses 1

Addresses

Other names 1

• Physical Therapy Doing business as

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Locations

Practitioners 6

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

• Kirk Conway, PT

  • Physical Therapist
  • Prince Frederick, MD
  • NPI 1578645933
  Medicare reassignment Care Compare group NPD Authorized official
• Christopher Paul Dudley, MPT

  • Physical Therapist
  • Prince Frederick, MD
  • NPI 1053325712
  Medicare reassignment Care Compare group NPD
• Larry Holland, DPT

  • Physical Therapist
  • Prince Frederick, MD
  • NPI 1811496110
  Medicare reassignment Care Compare group NPD
• Richard Alexander Matthews, DPT

  • Physical Therapist
  • Prince Frederick, MD
  • NPI 1154606796
  Medicare reassignment Care Compare group NPD
• Heather Allen, PT

  • Physical Therapist
  • Lusby, MD
  • NPI 1316029788
  NPD (past)
• Margie Ridgely, PT, MSPT

  • Physical Therapist
  • Prince Frederick, MD
  • NPI 1811277585
  NPD (past)

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

{
    "created_epoch": "1182124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224547200000",
    "number": "1780889154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 MAIN STREET",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "20678",
            "telephone_number": "410-610-4926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 MAIN STREET",
            "city": "PRINCE FREDERICK",
            "state": "MD",
            "postal_code": "20678",
            "telephone_number": "410-610-4926"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K CONWAY PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-18",
        "last_updated": "2008-10-21",
        "status": "A",
        "authorized_official_last_name": "CONWAY",
        "authorized_official_first_name": "KIRK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-610-4926",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MD",
            "license": "17145",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jessica Lynn Jones, PAC
• Joseph S. Fastow, M.D., P.a.
• Anson Joseph, M.D.,
• Charles A Judge, M.D.
• Autumn Blythe Jurasevich
• Haasya Kanamarlapudi
• Sellina V. Kaylor, LCSW-C
• Kidist Mulugeta Kebede, PHARMD
• Brandi Keen, CSC-AD
• Samantha L Keiter, PAC

• Physical Therapy Clinic/Center in Prince Frederick, MD
• Providers in Prince Frederick, 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 Oct 21, 2008; 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.