Individual provider Active NPI

Elizabeth Tarantula, PT

  • Physical Therapist
  • Baltimore, MD
National Provider Identifier
1932510765
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
22304 Issued in MD
Practice address
5601 Loch Raven Blvd
O'Neill BLDG, 2ND Floor, Outpatient Rehab
Baltimore, MD 21239-2945
Phone
(443) 444-4600
Fax
(443) 444-4607
NPI assigned
May 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 22304 MD Primary

Addresses

Primary practice location

5601 Loch Raven Blvd
O'Neill BLDG, 2ND Floor, Outpatient Rehab
Baltimore, MD 21239-2945

Mailing address

5445 Loch Raven Blvd Ste 403B
Baltimore, MD 21239-2943
Phone (443) 444-5757

Other names 1

  • Elizabeth Lawrence Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
22304MDMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1400025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706832000000",
    "number": "1932510765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5445 LOCH RAVEN BLVD STE 403B",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212392943",
            "telephone_number": "443-444-5757",
            "fax_number": "443-444-5750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5601 LOCH RAVEN BLVD",
            "address_2": "O'NEILL BLDG, 2ND FLOOR, OUTPATIENT REHAB",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212392945",
            "telephone_number": "443-444-4600",
            "fax_number": "443-444-4607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARANTULA",
        "first_name": "ELIZABETH",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-14",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "22304",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "LAWRENCE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2024; 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.