Individual provider Active NPI

Laurence R Gallager Jr., P.T.

  • Physical Therapist
  • Baltimore, MD
National Provider Identifier
1952435513
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
16054 Issued in MD
Practice address
3104 Lord Baltimore Dr
Suite 100
Baltimore, MD 21244-2898
Phone
(410) 298-0990
Fax
(410) 298-0871
NPI assigned
Mar 15, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 16054 MD Primary

Addresses

Primary practice location

3104 Lord Baltimore Dr
Suite 100
Baltimore, MD 21244-2898

Mailing address

3022 Cluster Pines CT
Ellicott City, MD 21042-7619
Phone (410) 461-3861

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230727001908 DC Practitioner - Physical Therapist in Private Practice 4880055573 Reassigns benefits to 1 organization
I20230727002197 MD Practitioner - Physical Therapist in Private Practice 4880055573 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Rehab PT MD LLCGroup PAC ID 6709028822, 92 clinicians

Practice addresses (Care Compare)

6451 N Charles St
Baltimore, MD 21212-1010
Phone (877) 407-3422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16054MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehab PT MD LLC Physical Therapist CurrentSince Jul 1, 2023 Accepting new patients
Fox Rehabilitation Services LLC Physical Therapist CurrentSince Jul 1, 2023 Accepting new patients
Kernan Physical Therapy Past Accepting new patients

Locations

11665 Doolittle Dr
Waldorf, MD 20602
Phone (301) 638-4100

7 Carnegie Plz
Cherry Hill, NJ 08003

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952435513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3022 CLUSTER PINES CT",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427619",
            "telephone_number": "410-461-3861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3104 LORD BALTIMORE DR",
            "address_2": "SUITE 100",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212442898",
            "telephone_number": "410-298-0990",
            "fax_number": "410-298-0871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLAGER",
        "first_name": "LAURENCE",
        "middle_name": "R",
        "name_suffix": "Jr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "16054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.