NPIMap

Organization Active NPI

Maximum Performance Physical Therapy, Inc

  • Physical Therapist
  • Laurel, MD
National Provider Identifier
1861600868
Registry record updated Oct 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
MAXIMUM PERFORMANCE PHYSICAL THERAPY, INC
Practice address
14504 Greenview Dr Ste 106
Laurel, MD 20708-4224
Phone
(301) 776-3665
Fax
(301) 776-6669
NPI assigned
May 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2022

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

Authorized official

Name
Kevin M Rich
Title
Cfo
Phone
(301) 776-3665

Specialties & licenses 1

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

Addresses

Primary practice location

14504 Greenview Dr Ste 106
Laurel, MD 20708-4224

Mailing address

14504 Greenview Dr Ste 106
Laurel, MD 20708-4224
Phone (301) 776-3665

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031103000457 DC Part B Supplier - Clinic/Group Practice 2062324601 Receives reassigned benefits from 9 practitioners
Practice locations: Laurel, MD

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Maximum Performance Physical Therapy2 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.

Locations

1360 Blair Dr
Ste D
Odenton, MD 21113
Phone (410) 672-8970

Practitioners & affiliated clinicians

Practitioners 12

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

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666915200000",
    "number": "1861600868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14504 GREENVIEW DR STE 106",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207084224",
            "telephone_number": "301-776-3665",
            "fax_number": "301-776-6669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14504 GREENVIEW DR STE 106",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207084224",
            "telephone_number": "301-776-3665",
            "fax_number": "301-776-6669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAXIMUM PERFORMANCE PHYSICAL THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A",
        "authorized_official_last_name": "RICH",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "301-776-3665"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2022; 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.