MARYLAND SPORTS, SPINE AND MUSCULOSKELETAL INSTITUTE (NPI# 1528586948) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528586948 |
| Entity Type | Organization |
| Organization Name | MARYLAND SPORTS, SPINE AND MUSCULOSKELETAL INSTITUTE |
| Other Organization Name | MSSMI |
| Practice Address |
8096 Edwin Raynor Blvd Ste C Pasadena MD 21122-6837 |
| Mailing Address |
2860 Deerfield Dr Ellicott City MD 21043-3490 |
| Practice Telephone | 2404604661 |
| Mailing Telephone | 2404604661 |
| Enumeration Date | 2017-09-06 |
| Last Update Date | 2017-09-06 |
| Authorized Official Name | JUSTIN WALTROUS (OWNER) |
| Authorized Official Telephone | 2404604661 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2081S0010X |
Physical Medicine & Rehabilitation Specialization: Sports Medicine |
D0077249 | MD | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| MSSMI | Doing Business As Name - Organization |
| Street Address |
8096 EDWIN RAYNOR BLVD STE C |
| City | PASADENA |
| State | MD |
| Zip Code | 21122-6837 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679890636 | Justin D Waltrous | Physical Medicine & Rehabilitation | 8096 Edwin Raynor Blvd Ste C, Pasadena, MD 21122-6837 | 2010-04-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740889211 | Hyunji Lee | Pharmacist | 8107 Governor Ritchie Highway, Pasadena, MD 21122 | 2020-10-25 |
| 1538712625 | Liri Fusha | Clinic/Center | 8221 Richie Hwy Suit #102, Pasadena, MD 21122 | 2019-07-18 |
| 1730649922 | Barrett Arthur Tollenger | Counselor | 2825 Mountain Road, Suite 204, Pasadena, MD 21122 | 2019-03-22 |
| 1750849543 | Bradley J Spoon | Counselor | 8028 Ritchie Highway St. 312, Pasadena, MD 21122 | 2019-03-11 |
| 1366916553 | Brittney Byrd | Behavior Technician | 7759 Middlegate Ct, Pasadena, MD 21122 | 2019-01-22 |
| 1780154310 | Amanda Ann Zeller | Speech-Language Pathologist | 8515 Jenkins Road, Pasadena, MD 21122 | 2018-11-27 |
| 1225531544 | Anne Arundel-sca Surgicenter, LLC | Clinic/Center | 8109 Ritchie Hwy Ste 250, Pasadena, MD 21122 | 2018-03-13 |
| 1629577424 | Anne Arundel Physician Group, LLC | Obstetrics & Gynecology | 18 Magothy Beach Road Suite A, Pasadena, MD 21122 | 2018-02-07 |
| 1063968261 | Chinedu Ikpemo | Pharmacist | 8051 Fort Smallwood Rd, Pasadena, MD 21122 | 2016-08-28 |
| 1053728634 | Wisecare, LLC | Clinic/Center | 33 Magothy Beach Rd, Suite 102-103, Pasadena, MD 21122 | 2014-07-16 |
| Find all providers in zip 21122 | ||||
| Taxonomy Code | 2081S0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Physical Medicine & Rehabilitation |
| Specialization | Sports Medicine |
| A physician who specializes in Sports Medicine is responsible for continuous care related to the enhancement of health and fitness as well as the prevention of injury and illness. The specialist possesses knowledge and experience in the promotion of wellness and the prevention of injury from many areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation and injuries. It is the goal of a Sports Medicine specialist to improve the healthcare of the individual engaged in physical exercise. |
| Notes: Source: American Board of Medical Specialties, 2009. www.abms.org [7/1/2009: definition added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679890636 | Justin D Waltrous | Physical Medicine & Rehabilitation | 8096 Edwin Raynor Blvd Ste C, Pasadena, MD 21122-6837 | 2010-04-29 |
| 1184854671 | Edico Health Care Corporation | Physical Medicine & Rehabilitation | 1737 E. Washington Blvd., Pasadena, CA 91104 | 2009-07-20 |
| 1659477487 | Risser Orthopaedic Group, A Medical Corporation | Physical Medicine & Rehabilitation | 2627 E Washington Blvd, Pasadena, CA 91107-1412 | 2006-09-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134758527 | Mechelle Suezette Norris | Physical Medicine & Rehabilitation | Loyola University Maryland Athletics, 4501 N Charles St., Baltimore, MD 21210 | 2020-04-07 |
| 1891352241 | Dawn Thomas | Physical Medicine & Rehabilitation | 11392 Livingston Rd, Fort Washington, MD 20744-5143 | 2019-05-21 |
| 1497220271 | Thomas Andrew Allen | Physical Medicine & Rehabilitation | 10801 Bellehaven Blvd, Damascus, MD 20872-2201 | 2018-10-09 |
| 1003313966 | Performance Physical Therapy and Sports Rehabilitation LLC | Physical Medicine & Rehabilitation | 5501 Twin Knolls Rd Ste 111, Columbia, MD 21045-3260 | 2018-04-09 |
| 1760877492 | Marc Philip Gruner | Physical Medicine & Rehabilitation | 6608 River Trail Ct, Bethesda, MD 20817-4324 | 2015-03-31 |
| 1811181795 | Barbara Semakula | Physical Medicine & Rehabilitation | 9700 Veirs Dr, Rockville, MD 20850 | 2007-09-04 |
| 1033111950 | Brian Yongtae Kim | Physical Medicine & Rehabilitation | 5 Executive Park Ct, Germantown, MD 20874-2643 | 2005-08-11 |
| 1275180424 | Johns Hopkins University | Physical Medicine & Rehabilitation | 600 N Wolfe St, Baltimore, MD 21287-0005 | 2019-08-22 |
| 1528614690 | Resilient Physiotherapy | Physical Medicine & Rehabilitation | 8303 Pulaski Hwy, Baltimore, MD 21237-2962 | 2019-08-14 |
| 1073166542 | Edith Callahan | Physical Medicine & Rehabilitation | 7 W Ridgely Rd Ste A, Timonium, MD 21093-5135 | 2019-07-23 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.