Prestige Physical Therapy, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

140233 Issued in MD

Legal business name

PRESTIGE PHYSICAL THERAPY, LLC

Practice address

186 Thomas Johnson Dr Ste 105
Frederick, MD 21702-4315

Phone

(301) 829-6770

Fax

(301) 829-6610

NPI assigned

Apr 17, 2009

Last updated

Apr 17, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Richard E Dixon Jr., PTNPI 1083891790

Title

Owner

Phone

(301) 829-6770

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Richard Edward Dixon Jr.

  • Physical Therapist
  • Mount Airy, MD
  • NPI 1083891790
  NPD (past) Authorized official

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

{
    "created_epoch": "1239926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239926400000",
    "number": "1912140112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23202 BREWERS TAVERN WAY",
            "city": "CLARKSBURG",
            "state": "MD",
            "postal_code": "208714391",
            "telephone_number": "301-829-6770",
            "fax_number": "301-829-6610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 THOMAS JOHNSON DR STE 105",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024315",
            "telephone_number": "301-829-6770",
            "fax_number": "301-829-6610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-17",
        "last_updated": "2009-04-17",
        "status": "A",
        "authorized_official_last_name": "DIXON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-829-6770",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MD",
            "license": "140233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Premier Orthopedics, P.a.
• Premier Primary Care LLC
• Premise Health of Maryland Medical P C (On-site US Employee Health & Wellness Center - Frederick)
• Premise Health of Maryland Medical P C (Homewood - Frederick)
• Premise Health of Maryland Medical P C (Kite Employee Health Center)
• Alex Prete
• Laura Lee Previte, RN, CDE
• Emily Preza
• Dinah Price, NP
• Jill Price

• Physical Therapy Clinic/Center in Frederick, MD
• Providers in Frederick, MD by specialty
• Physical Therapy Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2009; 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.