NPIMap

Organization Active NPI

Evidence Physical Therapy, LLC

  • Physical Therapist
  • Laurel, MD
National Provider Identifier
1972329506
Registry record updated Nov 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
EVIDENCE PHYSICAL THERAPY, LLC
Practice address
14501 Baltimore Ave
Laurel, MD 20707-4901
Phone
(301) 799-9466
Fax
(301) 799-9467
NPI assigned
Nov 27, 2024
Last updated
Nov 27, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2024

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

Authorized official

Name
Hassana Moses
Title
Practice Administrator
Phone
(301) 352-8370

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

14501 Baltimore Ave
Laurel, MD 20707-4901

Mailing address

12150 Annapolis Rd Ste 201
Glenn Dale, MD 20769-9183
Phone (301) 352-8370

National Provider Directory

National Provider Directory
Tax ID family
Evidence Phyl Thpy LLC4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Locations

14501 Baltimore Ave
Laurel, MD 20707
Phone (301) 799-9466

Practitioners & affiliated clinicians

Practitioners 3

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": "1732665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732665600000",
    "number": "1972329506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12150 ANNAPOLIS RD STE 201",
            "city": "GLENN DALE",
            "state": "MD",
            "postal_code": "207699183",
            "telephone_number": "301-352-8370",
            "fax_number": "301-352-8372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14501 BALTIMORE AVE",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207074901",
            "telephone_number": "301-799-9466",
            "fax_number": "301-799-9467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVIDENCE PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-11-27",
        "last_updated": "2024-11-27",
        "certification_date": "2024-11-27",
        "status": "A",
        "authorized_official_last_name": "MOSES",
        "authorized_official_first_name": "HASSANA",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "301-352-8370"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 27, 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.