NPIMap

Organization Active NPI

Professional Sportscare & Rehab Associates, LLC

  • Physical Therapist
  • College Park, MD
National Provider Identifier
1902911233
Registry record updated Feb 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PROFESSIONAL SPORTSCARE & REHAB ASSOCIATES, LLC
Practice address
4321 Hartwick Rd
Suite 101
College Park, MD 20740-3210
Phone
(301) 277-6616
Fax
(301) 277-6618
NPI assigned
Aug 19, 2006
Last updated
Feb 3, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2020

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

Authorized official

Name
Penny Pearson
Title
Dir, Revenue Cycle Management
Phone
(443) 225-4492

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

4321 Hartwick Rd
Suite 101
College Park, MD 20740-3210

Mailing address

350 New Fidelity CT
Garner, NC 27529-2665
Phone (919) 258-2714

National Provider Directory

National Provider Directory

Locations

511 Jermor Ln
Ste 203
Westminster, MD 21157

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580688000000",
    "number": "1902911233",
    "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": "4321 HARTWICK RD",
            "address_2": "SUITE 101",
            "city": "COLLEGE PARK",
            "state": "MD",
            "postal_code": "207403210",
            "telephone_number": "301-277-6616",
            "fax_number": "301-277-6618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL SPORTSCARE & REHAB ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2020-02-03",
        "certification_date": "2020-02-03",
        "status": "A",
        "authorized_official_last_name": "PEARSON",
        "authorized_official_first_name": "PENNY",
        "authorized_official_title_or_position": "DIR, REVENUE CYCLE MANAGEMENT",
        "authorized_official_telephone_number": "443-225-4492"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in College Park, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2020; 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.