ACTIVE PHYSICAL THERAPY SERVICES, LLC
Complete NPI Record 1225217334
Physical Therapist in Laurel, MD
Active since October 25, 2007
Complete NPI Dataset
This page contains the complete raw NPPES record for Active Physical Therapy Services, Llc (NPI 1225217334), a physical therapist organization in Laurel, MD. All 40 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.
Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, Markdown or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.
Registry File Document Utilities
- NPI: 1225217334 Field 1/40
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 2 Field 2/40
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Employer Identification Number EIN: Not available Field 3/40
- The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
- Provider Organization Name Legal Business Name: ACTIVE PHYSICAL THERAPY SERVICES, LLC Field 4/40
- The name of the organization provider. If the provider is an organization, this is the legal business name.
- Provider First Line Business Mailing Address: PO BOX 419666 Field 5/40
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Business Mailing Address City Name: BOSTON Field 6/40
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: MA Field 7/40
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
- Provider Business Mailing Address Postal Code: 022419666 Field 8/40
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
- Provider Business Mailing Address Country Code If outside U S : US Field 9/40
- The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
- Provider Business Mailing Address Telephone Number: 4109708190 Field 10/40
- The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
- Provider Business Mailing Address Fax Number: 4103138314 Field 11/40
- The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
- Provider First Line Business Practice Location Address: 14405 LAUREL PL Field 12/40
- The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Second Line Business Practice Location Address: STE 102 Field 13/40
- The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Business Practice Location Address City Name: LAUREL Field 14/40
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: MD Field 15/40
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 207076102 Field 16/40
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US Field 17/40
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 3014981604 Field 18/40
- The telephone number associated with the location address of the provider being identified.
- Provider Business Practice Location Address Fax Number: 3014981608 Field 19/40
- The fax number associated with the location address of the provider being identified.
- Authorized Official Last Name: BRAY Field 22/40
- The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
- Authorized Official First Name: THOMAS Field 23/40
- The first name of the authorized official.
- Authorized Official Title or Position: DIRECTOR Field 24/40
- The title or position of the authorized official.
- Authorized Official Telephone Number: 7032392310 Field 25/40
- The 10-position telephone number of the authorized official.
- Healthcare Provider Taxonomy Code 1: 111N00000X Field 26/40
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Healthcare Provider Primary Taxonomy Switch 1: N Field 27/40
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 2: 225X00000X Field 28/40
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Healthcare Provider Primary Taxonomy Switch 2: N Field 29/40
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 3: 225100000X Field 30/40
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Healthcare Provider Primary Taxonomy Switch 3: Y Field 31/40
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Other Provider Identifier 1: 8825 Field 32/40
- An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
- Other Provider Identifier Type Code 1: 01 Field 33/40
- A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
- Other Provider Identifier State 1: MD Field 34/40
- The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
- Other Provider Identifier Issuer 1: CAREFIRST BCBS Field 35/40
- The name of the organization, agency, or health plan that assigned the additional provider identifier. This identifies who issued the number linked to Other Provider Identifier 1 (for example, a state Medicaid agency, Medicare, or a private insurance company).
- Is Organization Subpart: N Field 36/40
- Indicates whether the provider is a subpart of a larger organization. This is a single-character code: "Y" means the entity is an organizational subpart, while "N" means it is not. Subparts typically include hospital departments, clinics, or other distinct units that fall under a parent organization.
- Healthcare Provider Taxonomy Group 1: 193200000X MULTI-SPECIALTY GROUP Field 37/40
- Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
- Healthcare Provider Taxonomy Group 2: 193200000X MULTI-SPECIALTY GROUP Field 38/40
- Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
- Healthcare Provider Taxonomy Group 3: 193200000X MULTI-SPECIALTY GROUP Field 39/40
- Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
Secondary Practice Locations 14
The first line of the secondary practice location address of the provider being identified. For providers with more than one physical location, this is a secondary practice location address. This address cannot include a Post Office box.
9135 Piscataway Rd Ste 305
Location 1/14Clinton, MD 20735-2554 · Phone (301) 877-2323
7300 Ritchie Hwy Ste 104
Location 2/14Glen Burnie, MD 21061-3393 · Phone (410) 863-5939
1535 University Blvd E Ste D
Location 3/14Hyattsville, MD 20783-4694 · Phone (301) 434-1850
650 Pennsylvania Ave SE Ste 170
Location 4/14Washington, DC 20003-4338 · Phone (202) 544-4874
809 N Charles St Ste 201
Location 5/14Baltimore, MD 21201-5307 · Phone (410) 837-4171
8887 Woodyard Rd
Location 6/14Clinton, MD 20735-2754 · Phone (301) 877-5460
7021 Martin Luther King Jr Hwy
Location 7/14Landover, MD 20785-4016 · Phone (301) 341-4600
5474 Saint Barnabas Rd Unit S
Location 8/14Oxon Hill, MD 20745-3622 · Phone (301) 505-0555
3200 Tower Oaks Blvd Ste 450
Location 9/14Rockville, MD 20852-4225 · Phone (301) 881-4610
3165 Crain Hwy
Location 10/14Waldorf, MD 20603-4847 · Phone (301) 885-2500
3742 10th St NE
Location 11/14Washington, DC 20017-1820 · Phone (202) 269-0358
211 Perry Pkwy Ste 1
Location 12/14Gaithersburg, MD 20877-2144 · Phone (301) 916-8540
1515 Merritt Blvd
Location 13/14Dundalk, MD 21222-2113 · Phone (410) 285-0920
6201 Greenbelt Rd Ste U15
Location 14/14Berwyn Heights, MD 20740-2347 · Phone (301) 220-0571
Other Provider Identifiers 1
Legacy and payer-issued identifiers reported to the NPPES registry for this provider.
8825 Other
Identifier 1/1State: MD · Issuer: Carefirst Bcbs
Other: An additional provider identifier that does not correspond to any of the other defined identifier type categories.
Other: An additional provider identifier that does not correspond to any of the other defined identifier type categories.
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