Derek Stanley, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

26794 Issued in MD

Practice address

1207 Liberty Rd Ste 106
Eldersburg, MD 21784-6574

Phone

(410) 549-5700

Fax

(410) 549-6200

NPI assigned

May 10, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC, MD2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Maryland Sportscare and Rehab LLCGroup PAC ID 2860440427, 166 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Maryland Sportscare & Rehab LLC

  • Physical Therapist
  • Westminster, MD
  • NPI 1518951995

  DC

  Medicare reassignment Care Compare group NPD
• Maryland Sportscare & Rehab, LLC

  • Physical Therapist
  • Westminster, MD
  • NPI 1720445174
  NPD

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

{
    "created_epoch": "1494374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560384000000",
    "number": "1861928947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 NEW FIDELITY CT",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275292665",
            "telephone_number": "919-258-2714",
            "fax_number": "410-648-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1207 LIBERTY RD STE 106",
            "city": "ELDERSBURG",
            "state": "MD",
            "postal_code": "217846574",
            "telephone_number": "410-549-5700",
            "fax_number": "410-549-6200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12158 Central Ave",
            "address_purpose": "LOCATION",
            "city": "Mitchellville",
            "state": "MD",
            "postal_code": "20721",
            "country_code": "US",
            "telephone_number": "301-390-3076",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STANLEY",
        "first_name": "DEREK",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-05-10",
        "last_updated": "2019-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "26794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Ann Smith, RDH
• Tiffany Smith
• Emma G. Sorenson, PA-C
• Fallon Mackenzie Spittel
• St. Agnes Healthcare, Inc.
• Melissa Stansbury, NBC-HWC, ACSM-EP
• Statcare Group LLC
• Spencer Sean Stcyr, D.D.S
• Nicole Stefan, COTA/L
• Steven Billet, M.D.P.a.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.