Executive Rehabilitation & Sports Therapy, Inc.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

14262 Issued in MD

Legal business name

EXECUTIVE REHABILITATION & SPORTS THERAPY, INC.

Practice address

6000 Executive Blvd
Suite #201
Rockville, MD 20852-3803

Phone

(301) 816-0020

Fax

(301) 816-0334

NPI assigned

Mar 22, 2006

Organization subpart

No

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

Authorized official

Name

Mr. John B SargeantNPI 1528060837

Title

Owner

Phone

(301) 816-0020

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John B Sargeant, PT

  • Physical Therapist
  • Rockville, MD
  • NPI 1528060837
  NPD (past) Authorized official
• Gary Lin, P.T.

  • Physical Therapist
  • Potomac, MD
  • NPI 1538293634
  NPD (past)

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992764492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6000 EXECUTIVE BLVD",
            "address_2": "SUITE #201",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208523803",
            "telephone_number": "301-816-0020",
            "fax_number": "301-816-0334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 EXECUTIVE BLVD",
            "address_2": "SUITE #201",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208523803",
            "telephone_number": "301-816-0020",
            "fax_number": "301-816-0334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXECUTIVE REHABILITATION & SPORTS THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SARGEANT",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "301-816-0020",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "14262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS/ NON PAR",
            "identifier": "K366",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Hamza Ewing
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• Experteeth Academy
• Expression Pathology Incorporated
• Expressive Therapy Center, LLC

• Physical Therapist in Rockville, MD
• Providers in Rockville, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.