NPIMap

Organization Active NPI

Fitness Forum of Maryland, LLC

  • Rehabilitation Practitioner
  • Annapolis, MD
National Provider Identifier
1912930835
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Legal business name
FITNESS FORUM OF MARYLAND, LLC
Practice address
2448 Holly Ave
Suite 200
Annapolis, MD 21401-3148
Phone
(410) 295-4941
Fax
(410) 295-5207
NPI assigned
Jul 7, 2006
Last updated
Mar 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

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

Authorized official

Name
Mrs. Janice M Baldwin
Title
Regional Manager
Phone
(410) 831-3226

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 225400000X Primary

Addresses

Primary practice location

2448 Holly Ave
Suite 200
Annapolis, MD 21401-3148

Mailing address

659 S Salisbury Blvd
Suite 1B
Salisbury, MD 21801-5453
Phone (410) 831-3226

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040407001472 MD Part B Supplier - Clinic/Group Practice 3971596537 Receives reassigned benefits from 24 practitioners
Practice locations: Annapolis, MD; Chester, MD
O20250113000375 MD DME Supplier - Independently-Practicing Physical Therapist 3971596537 Practice locations: Annapolis, MD

National Provider Directory

National Provider Directory
Tax ID family
Fitness Forum of Maryland LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1981 Moreland Pkwy
Annapolis, MD 21401
Phone (410) 280-5170

2448 Holly Ave
Ste 200
Annapolis, MD 21401
Phone (410) 295-4941

1915 Main St
Chester, MD 21619
Phone (443) 909-5882

Practitioners & affiliated clinicians

Practitioners 41

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.

View all 41

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709510400000",
    "number": "1912930835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "659 S SALISBURY BLVD",
            "address_2": "SUITE 1B",
            "city": "SALISBURY",
            "state": "MD",
            "postal_code": "218015453",
            "telephone_number": "410-831-3226",
            "fax_number": "410-572-4041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2448 HOLLY AVE",
            "address_2": "SUITE 200",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214013148",
            "telephone_number": "410-295-4941",
            "fax_number": "410-295-5207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FITNESS FORUM OF MARYLAND, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-07",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-04",
        "status": "A",
        "authorized_official_last_name": "BALDWIN",
        "authorized_official_first_name": "JANICE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "REGIONAL MANAGER",
        "authorized_official_telephone_number": "410-831-3226",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2024; 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.