Carly Stock, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

23227 Issued in MD

Practice address

2314 Pulaski Hwy
Suite a
North East, MD 21901-3730

Phone

(410) 287-2940

Fax

(410) 287-2941

NPI assigned

May 6, 2013

Last updated

Dec 11, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Carly Matichak Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1367798400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449792000000",
    "number": "1871938852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2314 PULASKI HWY",
            "address_2": "SUITE A",
            "city": "NORTH EAST",
            "state": "MD",
            "postal_code": "219013730",
            "telephone_number": "410-287-2940",
            "fax_number": "410-287-2941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOCK",
        "first_name": "CARLY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-06",
        "last_updated": "2015-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "23227",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "020439",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARLY",
            "last_name": "MATICHAK",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Amanda Sleime, PHARMD
• David Smith
• Jill Stanford-Jicha
• Susanna Stapleford, LGPC
• Sofia Bermudez Stewart, MD
• Julia Marie Strazzella, CF-SLP
• Nattawan Suwannimit
• Sweet Dreams Anesthesia, LLC
• Vilma Fondevilla Tadalan-Velasco, M.D.
• Christina L Taylor, LCPC

• Physical Therapist in North East, MD
• Providers in North East, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2015; 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.