NPIMap

Organization Active NPI

Evidence Physical Therapy, LLC

  • Physical Therapist
  • Clinton, MD
National Provider Identifier
1982176988
Registry record updated Jan 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
EVIDENCE PHYSICAL THERAPY, LLC
Practice address
7801 Old Branch Ave Ste 105
Clinton, MD 20735-1641
Phone
(301) 856-8386
NPI assigned
Jan 2, 2019
Last updated
Jan 2, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
EVIDENCE PHYSICAL THERAPYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 2, 2019

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 TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

7801 Old Branch Ave Ste 105
Clinton, MD 20735-1641

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 Physical Therapy L4 organizations share this tax ID, including this one
Part of
Evidence Physical Therapy L

Other organizations with this tax ID 3

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

Locations

7801 Old Branch Ave
Ste 105
Clinton, MD 20735
Phone (301) 856-8386

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1546387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546387200000",
    "number": "1982176988",
    "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": "7801 OLD BRANCH AVE STE 105",
            "city": "CLINTON",
            "state": "MD",
            "postal_code": "207351641",
            "telephone_number": "301-856-8386"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVIDENCE PHYSICAL THERAPY, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EVIDENCE PHYSICAL THERAPY",
        "enumeration_date": "2019-01-02",
        "last_updated": "2019-01-02",
        "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": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2019; 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.