Strive Sports Medicine Physical Therapy, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

STRIVE SPORTS MEDICINE PHYSICAL THERAPY, LLC

Practice address

206 N Fruitland Blvd
Fruitland, MD 21826-1717

Phone

(410) 324-3301

Fax

(443) 775-7728

NPI assigned

Sep 25, 2020

Last updated

Apr 10, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Travis James Light, PTNPI 1083133102

Title

Owner

Phone

(443) 370-2106

Specialties & licenses 1

Addresses

Tax ID family

Strive Sports Medicine 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.

• Strive Sports Medicine Physical Therapy, LLC

  • Physical Therapist
  • Salisbury, MD
  • NPI 1578273629
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Strive Sports Medicine Physical Therapy, LLC

  • Physical Therapist
  • Salisbury, MD
  • NPI 1578273629
  NPPES parent name

Practitioners 1

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.

• Travis Light, PT

  • Physical Therapist
  • Salisbury, MD
  • NPI 1083133102
  NPD Authorized official

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

{
    "created_epoch": "1600992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649548800000",
    "number": "1811504608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 475",
            "city": "FRUITLAND",
            "state": "MD",
            "postal_code": "218260475",
            "telephone_number": "410-324-3301",
            "fax_number": "443-775-7728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 N FRUITLAND BLVD",
            "city": "FRUITLAND",
            "state": "MD",
            "postal_code": "218261717",
            "telephone_number": "410-324-3301",
            "fax_number": "443-775-7728"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "112 W Gordy Rd",
            "address_purpose": "LOCATION",
            "city": "Salisbury",
            "state": "MD",
            "postal_code": "218013309",
            "country_code": "US",
            "telephone_number": "410-324-3301",
            "fax_number": "443-775-7728",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "STRIVE SPORTS MEDICINE PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-25",
        "last_updated": "2022-04-10",
        "certification_date": "2022-04-10",
        "status": "A",
        "authorized_official_last_name": "LIGHT",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-370-2106",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

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