NPIMap

Organization Active NPI

Maryland Sportscare & Rehab LLC

Doing business as Pivot Physical Therapy of Maryland

  • Physical Therapist
  • Laurel, MD
National Provider Identifier
1932561644
Registry record updated Nov 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
MARYLAND SPORTSCARE & REHAB LLC
Doing business as
Pivot Physical Therapy of Maryland
Practice address
14700 Baltimore Ave
Ste 106
Laurel, MD 20707
Phone
(240) 754-2203
NPI assigned
Mar 22, 2016
Last updated
Nov 1, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2024

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

Authorized official

Name
Tasheda Broughton
Title
Credentialing Manager
Phone
(252) 248-3313

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary
Occupational Therapist 225X00000X NU

Addresses

Primary practice location

14700 Baltimore Ave
Ste 106
Laurel, MD 20707

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (522) 483-3132

Other names 1

  • Pivot Physical Therapy of Maryland Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Glen Burnie Physical Therapy Sportscare LLC9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

14700 Baltimore Ave
Unit 106
Laurel, MD 20707
Phone (240) 754-2203

NPI Registry JSON

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

{
    "created_epoch": "1458604800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730419200000",
    "number": "1932561644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "522-483-3132",
            "fax_number": "410-678-4878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14700 BALTIMORE AVE",
            "address_2": "STE 106",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "20707",
            "telephone_number": "240-754-2203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARYLAND SPORTSCARE & REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-22",
        "last_updated": "2024-11-01",
        "certification_date": "2024-11-01",
        "status": "A",
        "authorized_official_last_name": "BROUGHTON",
        "authorized_official_first_name": "TASHEDA",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "252-248-3313"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pivot Physical Therapy of Maryland",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Laurel, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 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.