Individual provider Active NPI

Elizabeth Lee Cavanagh, PTA

  • Physical Therapy Assistant
  • Leonardtown, MD
National Provider Identifier
1831630607
Registry record updated Mar 14, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
A1184 Issued in MD
Practice address
41680 Miss Bessie Dr
Suite 103
Leonardtown, MD 20650-2906
Phone
(240) 256-3711
Fax
(240) 256-3612
NPI assigned
Mar 14, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X A1184 MD Primary

Addresses

Primary practice location

41680 Miss Bessie Dr
Suite 103
Leonardtown, MD 20650-2906

Mailing address

41680 Miss Bessie Dr
Suite 103
Leonardtown, MD 20650-2906
Phone (240) 256-3711

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

LicenseStateTypeSpecialty
A1184MDMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1489449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489449600000",
    "number": "1831630607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41680 MISS BESSIE DR",
            "address_2": "SUITE 103",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206502906",
            "telephone_number": "240-256-3711",
            "fax_number": "240-256-3612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41680 MISS BESSIE DR",
            "address_2": "SUITE 103",
            "city": "LEONARDTOWN",
            "state": "MD",
            "postal_code": "206502906",
            "telephone_number": "240-256-3711",
            "fax_number": "240-256-3612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVANAGH",
        "first_name": "ELIZABETH",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-03-14",
        "last_updated": "2017-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MD",
            "license": "A1184",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leonardtown, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2017; 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.