PROFORMANCE SPORTS REHABILITATION (NPI# 1720562069) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720562069 |
| Entity Type | Organization |
| Organization Name | PROFORMANCE SPORTS REHABILITATION |
| Practice Address |
2637 Streamview Dr Odenton MD 21113-1579 |
| Practice Telephone | 8609177610 |
| Mailing Telephone | 8609177610 |
| Enumeration Date | 2018-09-22 |
| Last Update Date | 2018-09-22 |
| Authorized Official Name | MR. BRANDEN JACK COHEN (OWNER/PHYSICAL THERAPIST) |
| Authorized Official Telephone | 8609177610 |
| Authorized Official Credential | DPT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2251S0007X |
Physical Therapist Specialization: Sports |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
2637 STREAMVIEW DR |
| City | ODENTON |
| State | MD |
| Zip Code | 21113-1579 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154622199 | Branden Jack Cohen | Physical Therapist | 2637 Streamview Dr, Odenton, MD 21113-1579 | 2010-11-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366938599 | Dmv Community Health Services LLC | Clinic/Center | 87778 Pine Orchard Parkway, Odenton, MD 21113 | 2018-07-11 |
| 1285125997 | Edward Lashawn Harvey | Specialist | 207 Ammunition Ave, Odenton, MD 21113 | 2018-05-29 |
| 1275041394 | Aimee Kathleen Olivera Sanchez | Social Worker | 2150 Colonel Way, Odenton, MD 21113 | 2018-01-11 |
| 1891214714 | Bincy Kuttiplackal Mathai | Dentist | 1135 Annapolis Road, Odenton, MD 21113 | 2017-09-12 |
| 1730601949 | Amanda Mary Jackiewicz | Physician Assistant | Greater Maryland Pain Management, 1130 Annapolis Rd Suite 100, Odenton, MD 21113 | 2017-07-10 |
| 1346771235 | Pattrena Reid | Respiratory Therapist, Registered | 115 Bragg Blvd, Odenton, MD 21113 | 2017-03-23 |
| 1225572233 | Pamela Denise Ponder | Internal Medicine | 2603 Portola Court, Odenton, MD 21113 | 2016-12-09 |
| 1285052803 | Diana Nicole Spell | Internal Medicine | Johns Hopkins Community Physicians - Odenton, 1106 Annapolis Road, Odenton, MD 21113 | 2014-04-01 |
| 1730431321 | Orthopedic Physicians of Annapolis LLC | Prosthetic/Orthotic Supplier | 1106 Annapolis Road, Suite 130, Odenton, MD 21113 | 2012-10-08 |
| 1275869463 | Olubukola Fakunle | Pharmacist | 2294 Blue Water Blvd, Weis Pharmacy, Odenton, MD 21113 | 2009-10-23 |
| Find all providers in zip 21113 | ||||
| Taxonomy Code | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053970889 | Caroline Victoria Vink | Physical Therapist | 1106 Annapolis Rd Ste 120, Odenton, MD 21113-1738 | 2019-06-05 |
| 1629265921 | Elizabeth Anne Kuklenski | Physical Therapist | 1215 Annapolis Rd, Ste. 204, Odenton, MD 21113-1344 | 2007-10-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528665262 | Ah Concierge Physical Therapy LLC | Physical Therapist | 5889 Solomons Island Road #626, Tracys Landing, MD 20779 | 2020-10-06 |
| 1417417163 | Elite Performance Institute LLC | Physical Therapist | 19719 Leitersburg Pike, Hagerstown, MD 21742-1443 | 2019-03-20 |
| 1942767439 | Lara Anderson | Physical Therapist | 23000 Moakley St Ste 101, Leonardtown, MD 20650-2916 | 2019-02-21 |
| 1619440203 | Daniel Moore Chapman | Physical Therapist | 3555 Newland Rd, Baltimore, MD 21218-2513 | 2019-01-07 |
| 1427532126 | Taylor Physical Therapy, P.C. | Physical Therapist | 2419 Whiteford Rd Ste A, Whiteford, MD 21160-1218 | 2018-09-18 |
| 1316438070 | Dylan Marks | Physical Therapist | 5024 Dorsey Hall Dr Ste 103, Ellicott City, MD 21042-7869 | 2018-05-29 |
| 1225529829 | Inspire Movement Physical Therapy, LLC | Physical Therapist | 3301 Ridge Rd, Westminster, MD 21157-7443 | 2018-05-21 |
| 1619480258 | Knicley Se, LLC | Physical Therapist | 3540 Sugarloaf Pkwy Ste D03, Frederick, MD 21704-7901 | 2017-11-06 |
| 1033620539 | Adam Fuehrer | Physical Therapist | 2 W Rolling Xrds, Catonsville, MD 21228-6208 | 2017-10-24 |
| 1881112282 | Michael John Ayun Ayun Cruz | Physical Therapist | 10301 Georgia Ave Suite 105b, Silver Spring, MD 20902 | 2017-09-06 |
| 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.