NPIMap

Organization Active NPI

Maryland Sportscare & Rehab, LLC

Doing business as Pivot Physical Therapy of Maryland

  • Physical Therapist
  • Westminster, MD
National Provider Identifier
1861858276
Registry record updated Oct 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
MARYLAND SPORTSCARE & REHAB, LLC
Doing business as
Pivot Physical Therapy of Maryland
Practice address
410 Meadow Creek Dr
Ste 106
Westminster, MD 21158-9426
Phone
(410) 861-5487
Fax
(443) 293-7924
NPI assigned
Jan 14, 2016
Last updated
Oct 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2024

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

Authorized official

Name
Tasheda Broughton, PESC
Title
Manager, Credentialling
Phone
(252) 248-3313

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

410 Meadow Creek Dr
Ste 106
Westminster, MD 21158-9426

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (522) 483-3132

Other names 1

  • PIVOT PHYSICAL THERAPY OF MARYLAND Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Maryland Sportscare Rehab LLC72 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 21

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1452729600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729036800000",
    "number": "1861858276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "522-483-3132",
            "fax_number": "410-648-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 MEADOW CREEK DR",
            "address_2": "STE 106",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211589426",
            "telephone_number": "410-861-5487",
            "fax_number": "443-293-7924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND SPORTSCARE & REHAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-14",
        "last_updated": "2024-10-16",
        "certification_date": "2024-10-16",
        "status": "A",
        "authorized_official_last_name": "BROUGHTON",
        "authorized_official_first_name": "TASHEDA",
        "authorized_official_title_or_position": "MANAGER, CREDENTIALLING",
        "authorized_official_telephone_number": "252-248-3313",
        "authorized_official_credential": "PESC"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PIVOT PHYSICAL THERAPY OF MARYLAND",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PIVOT PHYSICAL THERAPY OF MARYLAND",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Westminster, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2024; 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.