NPIMap

Organization Active NPI

Drayer Physical Therapy of Maryland LLC

  • Physical Therapy Clinic/Center
  • Fulton, MD
National Provider Identifier
1912528274
Registry record updated May 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
DRAYER PHYSICAL THERAPY OF MARYLAND LLC
Practice address
11710 E Market Place, Suite F
Fulton, MD 20759
Phone
(301) 490-0419
Fax
(410) 490-1260
NPI assigned
Apr 28, 2020
Last updated
May 12, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 12, 2020

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

Authorized official

Name
Beverly Ann Thomas
Title
Prov Enrollment Cred Specialist
Phone
(717) 839-2159

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NU Primary

Addresses

Primary practice location

11710 E Market Place, Suite F
Fulton, MD 20759

Mailing address

5300 Derry St FL 2
Harrisburg, PA 17111-3576
Phone (717) 839-2110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140602000154 MD Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3173746609 Receives reassigned benefits from 57 practitioners
6 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Aberdeen, MD; Baltimore, MD; Bel Air, MD; Cockeysville, MD; Elkton, MD; Fallston, MD; Forest Hill, MD; Fulton, MD…

Other NPIs on the same Medicare enrollment 6

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

11710 E Market Pl
Ste F
Fulton, MD 20759
Phone (301) 490-0419

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1588032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1589241600000",
    "number": "1912528274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 DERRY ST FL 2",
            "city": "HARRISBURG",
            "state": "PA",
            "postal_code": "171113576",
            "telephone_number": "717-839-2110",
            "fax_number": "717-565-1934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11710 E MARKET PLACE, SUITE F",
            "city": "FULTON",
            "state": "MD",
            "postal_code": "20759",
            "telephone_number": "301-490-0419",
            "fax_number": "410-490-1260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRAYER PHYSICAL THERAPY OF MARYLAND LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-28",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PROV ENROLLMENT CRED SPECIALIST",
        "authorized_official_telephone_number": "717-839-2159"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fulton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.