Provider Type Icon

FREDERICKS SPORT AND SPINE CLINIC INC NPI 1841204823


NPI Information

NPI: 1841204823
Provider Name: FREDERICKS SPORT AND SPINE CLINIC INC
Classification: Physical Therapist - 2251X0800X
Entity Type: Organization

Specialization: Orthopedic

Address:
84 THOMAS JOHNSON CT
SUITE B
FREDERICK, MD
ZIP 21702
Phone: (301) 662-8541
Get Directions

FREDERICKS SPORT AND SPINE CLINIC INC is an orthopedic physical therapist in Frederick, MD. The provider is a licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Orthopaedic Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science; pathology/pathophysiology, pain science, medical and surgical considerations, orthopaedic physical therapy theory and practice, and critical inquiry for evidence-based practice. FREDERICKS SPORT AND SPINE CLINIC INC NPI is 1841204823. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

84 THOMAS JOHNSON CT
SUITE B
FREDERICK, MD
ZIP 21702-348
Phone: (301) 662-8541
Fax: (301) 662-8762

The provider's authorized official is C Gooding .
The authorized official title is Credentialling Officer and has the following contact phone number (301) 662-8541.

The enumeration date for this NPI number is 7/28/2006 and was last updated on 6/4/2014.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12251X0800XPhysical TherapistOrthopedicYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1123MOTHERMARYLANDMEDICARE
2147719000OTHERMARYLANDDEPT OF LABOR
3551810OTHERMARYLANDMAMSI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.