NPIMap

Organization Active NPI

Synergy Therapy, LLC

Doing business as Synergy Physical Therapy

  • Physical Therapist
  • Fulton, MD
National Provider Identifier
1831225408
Registry record updated Oct 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
20478 Issued in MD
Legal business name
SYNERGY THERAPY, LLC
Doing business as
Synergy Physical Therapy
Practice address
7625 Maple Lawn Blvd
Suite 140
Fulton, MD 20759-2565
Phone
(301) 497-3070
Fax
(301) 497-3071
NPI assigned
Feb 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2010

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

Authorized official

Name
Michelle H Kim
Title
Manager
Phone
(301) 497-3070

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 20478 MD Primary

Addresses

Primary practice location

7625 Maple Lawn Blvd
Suite 140
Fulton, MD 20759-2565

Mailing address

7625 Maple Lawn Blvd
Suite 140
Fulton, MD 20759-2565
Phone (301) 497-3070

Other names 1

  • Synergy Physical Therapy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070705000478 MD Part B Supplier - Clinic/Group Practice 0446350490 Receives reassigned benefits from 3 practitioners
Practice locations: Fulton, MD

National Provider Directory

National Provider Directory

Locations

1915 Maryland Ave
Baltimore, MD 21218
Phone (410) 486-2298

9170 Rumsey Rd
Columbia, MD 21045
Phone (301) 497-3070

7625 Maple Lawn Blvd
Ste 140
Fulton, MD 20759
Phone (301) 497-3070

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1172448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288310400000",
    "number": "1831225408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7625 MAPLE LAWN BLVD",
            "address_2": "SUITE 140",
            "city": "FULTON",
            "state": "MD",
            "postal_code": "207592565",
            "telephone_number": "301-497-3070",
            "fax_number": "301-497-3071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7625 MAPLE LAWN BLVD",
            "address_2": "SUITE 140",
            "city": "FULTON",
            "state": "MD",
            "postal_code": "207592565",
            "telephone_number": "301-497-3070",
            "fax_number": "301-497-3071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYNERGY THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-26",
        "last_updated": "2010-10-29",
        "status": "A",
        "authorized_official_last_name": "KIM",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "301-497-3070"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "20478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Synergy Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fulton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2010; 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.