PRESTIGE PHYSICAL THERAPY, LLC (NPI# 1912140112) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912140112 |
| Entity Type | Organization |
| Organization Name | PRESTIGE PHYSICAL THERAPY, LLC |
| Practice Address |
186 Thomas Johnson Dr Ste 105 Frederick MD 21702-4315 |
| Mailing Address |
23202 Brewers Tavern Way Clarksburg MD 20871-4391 |
| Practice Telephone | 3018296770 |
| Practice Fax Number | 3018296610 |
| Mailing Telephone | 3018296770 |
| Mailing Fax Number | 3018296610 |
| Enumeration Date | 2009-04-17 |
| Last Update Date | 2009-04-17 |
| Authorized Official Name | MR. RICHARD E DIXON JR. (OWNER) |
| Authorized Official Telephone | 3018296770 |
| Authorized Official Credential | PT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
140233 | MD | Ambulatory Health Care Facilities |
| Street Address |
186 THOMAS JOHNSON DR STE 105 |
| City | FREDERICK |
| State | MD |
| Zip Code | 21702-4315 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184835720 | Sarabjit Kaur Singh | Internal Medicine | 186 Thomas Johnson Dr Ste 105, Frederick, MD 21702-4315 | 2007-05-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073129714 | Rita Akowuah | Nurse Practitioner | 1302 Baker Place East Apt 14, Frederick, MD 21702 | 2020-09-18 |
| 1912416272 | Morgan Nicely | Behavior Technician | 65 Thomas Johnson Drive Suite A, Frederick, MD 21702 | 2017-09-29 |
| 1154840494 | Centers for Advanced Orthopaedics, LLC | Orthopaedic Surgery | 184 Thomas Johnson Dr Ste 104, Frederick, MD 21702 | 2017-09-19 |
| 1831617471 | Hazel Elizabeth Gill | Physical Therapy Assistant | 2007 Butterfield Overlook, Frederick, MD 21702 | 2017-09-05 |
| 1831610161 | William Haynes | Nurse Practitioner | 103 Water Land Ct., Frederick, MD 21702 | 2017-06-27 |
| 1497299333 | Timothy Stimach | Pharmacist | 1430b W Patrick St, Frederick, MD 21702 | 2016-12-12 |
| 1184167405 | Maryland Nutrition and Diet Services, L.L.C. | Dietitian, Registered | 1301 W. 7th Street, No. 1607, Frederick, MD 21702 | 2016-11-18 |
| 1649649468 | Oluwakemi Olubunmi Osidele | Nurse Practitioner | 188 Thomas Johnson Dr Ste 102, Frederick, MD 21702 | 2015-09-22 |
| 1841678562 | Ventzislava Hristova | Spec/Tech, Pathology | 1050 Boyles St. Building 560 Room 12-39, National Cancer Institute - Frederick, Frederick, MD 21702 | 2015-05-14 |
| 1023404571 | Mychal Lynn Pilia | Advanced Practice Midwife | 7420 Hayward Road, Suite 104, Frederick, MD 21702 | 2015-04-11 |
| Find all providers in zip 21702 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215582499 | Bliss Physical Therapy and Wellness, LLC | Clinic/Center | 1404 Silverspot Ct, Frederick, MD 21703-5986 | 2019-08-05 |
| 1093250052 | Above All Physical Therapy LLC | Clinic/Center | 808 Toll House Ave, Frederick, MD 21701-4519 | 2016-12-30 |
| 1982061800 | Pediatric Physical Therapy and Yoga | Clinic/Center | 47 E South St, Suite 1-a, Frederick, MD 21701-5980 | 2016-01-22 |
| 1467757575 | Sage Physical Therapy & Wellness LLC | Clinic/Center | 3536a Urbana Pike, Frederick, MD 21704-7742 | 2011-01-20 |
| 1427118777 | Frederick Physical Therapy Inc. | Clinic/Center | 196 Thomas Johnson Dr Ste 225, Frederick, MD 21702-4528 | 2006-12-09 |
| 1821624776 | N Voc #20 | Clinic/Center | 319 E Josephine Ave, Frederick, OK 73542-2220 | 2020-03-22 |
| 1912431412 | North Place Operating Company LLC | Clinic/Center | 30 North Pl, Frederick, MD 21701-6200 | 2017-04-12 |
| 1952671075 | Montclaire Physical Therapy, LLC | Clinic/Center | 700 Montclaire Ave, Suite A, Frederick, MD 21701-4577 | 2012-01-05 |
| 1205024478 | Michael Gerard Schmitt | Clinic/Center | 196 Thomas Johnson Dr Ste 225, Frederick, MD 21702-4528 | 2007-10-12 |
| 1902990682 | Physiotherapy Associates Inc | Clinic/Center | 170 Thomas Johnson Dr, Suite 104, Frederick, MD 21702-4354 | 2006-10-03 |
| Find all providers in FREDERICK | ||||
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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.