NPIMap

Organization Active NPI

La Plata Physical Therapy

  • Specialist
  • La Plata, MD
National Provider Identifier
1972796357
Registry record updated Sep 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
15290 Issued in MD
Legal business name
LA PLATA PHYSICAL THERAPY
Practice address
101 Centennial St
Suite C
La Plata, MD 20646
Phone
(301) 392-3700
Fax
(301) 392-3876
NPI assigned
Aug 20, 2007
Last updated
Sep 5, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2008

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

Authorized official

Name
Jane Cunningham, MCSP, PTNPI 1619987955
Title
Owner
Phone
(301) 392-3700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 02404 MD
Specialist 174400000X 15290 MD Primary
Speech-Language Pathologist 235Z00000X 01154 MD

Addresses

Primary practice location

101 Centennial St
Suite C
La Plata, MD 20646

Mailing address

P.O. Box 1732
La Plata, MD 20646
Phone (301) 392-3700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071108000717 MD Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2365530318 Receives reassigned benefits from 4 practitioners
Practice locations: La Plata, MD

National Provider Directory

National Provider Directory
Tax ID family
La Plata Physical Therapy2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

101 Centennial St
Ste C
La Plata, MD 20646
Phone (301) 392-3700

Practitioners & affiliated clinicians

Practitioners 9

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": "1187568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220572800000",
    "number": "1972796357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1732",
            "city": "LA PLATA",
            "state": "MD",
            "postal_code": "20646",
            "telephone_number": "301-392-3700",
            "fax_number": "301-392-3876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 CENTENNIAL ST",
            "address_2": "SUITE C",
            "city": "LA PLATA",
            "state": "MD",
            "postal_code": "20646",
            "telephone_number": "301-392-3700",
            "fax_number": "301-392-3876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA PLATA PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-20",
        "last_updated": "2008-09-05",
        "status": "A",
        "authorized_official_last_name": "CUNNINGHAM",
        "authorized_official_first_name": "JANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-392-3700",
        "authorized_official_credential": "MCSP, PT"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MD",
            "license": "02404",
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MD",
            "license": "15290",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MD",
            "license": "01154",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Plata, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2008; 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.