Active NPI
Joseph Manabat Laxamana, PT
- Physical Therapist
- Ellicott City, MD
National Provider Identifier
1790044089
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 21829
- Practice address
- 3290 N Ridge Rd
Suite 290
Ellicott City, MD 21043-3655 - Phone
- (410) 750-1096
- Fax
- (410) 750-0787
- NPI assigned
- May 8, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 21829 | MD | Primary |
Addresses
Primary practice location
3290 N Ridge Rd
Suite 290
Ellicott City, MD 21043-3655
Mailing address
6612 Bonnie Ridge Dr
Apt 102
Baltimore, MD 21209-1936
Phone (443) 527-3341
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21829 | MD | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1336435200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1336435200000",
"number": "1790044089",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6612 BONNIE RIDGE DR",
"address_2": "APT 102",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212091936",
"telephone_number": "443-527-3341"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3290 N RIDGE RD",
"address_2": "SUITE 290",
"city": "ELLICOTT CITY",
"state": "MD",
"postal_code": "210433655",
"telephone_number": "410-750-1096",
"fax_number": "410-750-0787"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAXAMANA",
"first_name": "JOSEPH",
"middle_name": "MANABAT",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-05-08",
"last_updated": "2012-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "21829",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ellicott City, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.