PRESTIGE PHYSICAL THERAPY LLC (NPI# 1124263066) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124263066 |
| Entity Type | Organization |
| Organization Name | PRESTIGE PHYSICAL THERAPY LLC |
| Practice Address |
23202 Brewers Tavern Way Clarksburg MD 20871-4391 |
| Practice Telephone | 2402073090 |
| Practice Fax Number | 2402072182 |
| Mailing Telephone | 2402073090 |
| Mailing Fax Number | 2402072182 |
| Enumeration Date | 2008-12-05 |
| Last Update Date | 2008-12-24 |
| Authorized Official Name | DR. RICHARD E DIXON JR. (OWNER) |
| Authorized Official Telephone | 2402073090 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| Street Address |
23202 BREWERS TAVERN WAY |
| City | CLARKSBURG |
| State | MD |
| Zip Code | 20871-4391 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316439078 | Clarksburg Dermatology and Skincare LLC | Nurse Practitioner | 23202 Brewers Tavern Way, Clarksburg, MD 20871 | 2018-05-30 |
| 1912345471 | Clarksburg Eye Care, LLC | Optometrist | 23202 Brewers Tavern Way, Clarksburg, MD 20871-4391 | 2013-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366097578 | Shelah Maul | Speech-Language Pathologist | Clarksburg Elementary School, 13530 Redgrave Place, Clarksburg, MD 20871 | 2019-08-05 |
| 1013401769 | Thin Phyu Bur | Social Worker | 13446 Dutrow Dr, Clarksburg, MD 20871 | 2018-06-17 |
| 1750754925 | Milankumar Maheshbhai Patel | Physical Therapist | 23923 Basil Park Circle, Clarksburg, MD 20871 | 2015-11-09 |
| 1093142796 | Harris Teeter, LLC | Durable Medical Equipment & Medical Supplies | 22700 Sweet Shrub Drive, Clarksburg, MD 20871 | 2013-09-26 |
| 1932493046 | Chidinma Ebele | Case Management | 23447 Tailor Shop Pl, Clarksburg, MD 20871 | 2011-06-06 |
| 1396036455 | Reliance Home Care | Home Health | 12615 Blue Sky Drive, Clarksburg, MD 20871 | 2011-04-25 |
| 1063721629 | Clarksburg Medical Center Inc | Ophthalmology | 22616 Gateway Center Dr Ste 600a, Clarksburg, MD 20871 | 2010-09-30 |
| 1548440787 | Patricia J. Tucker | Social Worker | 21925 Frederick Rd, Clarksburg, MD 20871 | 2007-11-05 |
| 1487954509 | Sean Park | Pharmacist | 7025 Brookville Rd, Chevy Chase, MD 20871 | 2010-10-22 |
| 1528331881 | Bio Reference Laboratories, Inc | Clinical Medical Laboratory | 22520 Gateway Center Dr, Ste 400, Clarksburg, MD 20871-2005 | 2012-02-17 |
| Find all providers in zip 20871 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780026344 | Samantha Lawrence | Specialist | 610 Drummond St, Clarksburg, WV 26301-2250 | 2013-07-24 |
| 1962697532 | Urologist Inc | Specialist | 600 Davisson Run Rd Ste 201, Clarksburg, WV 26301-9307 | 2007-09-07 |
| 1801948252 | Fulvio Rogelio Franyutti | Specialist | 320 W Pike St, Suite 120, Clarksburg, WV 26301-2793 | 2007-01-17 |
| 1336106673 | Joseph C Kassis | Specialist | 600 Davisson Run Rd, Suite 201, Clarksburg, WV 26301-9307 | 2006-04-28 |
| 1629209705 | Tuscan Sun Spa | Specialist | 482 Emily Dr, Clarksburg, WV 26301-5514 | 2009-08-06 |
| 1578794764 | Melissa Kay Sayres | Specialist | 482 Emily Dr, Clarksburg, WV 26301-5514 | 2009-08-05 |
| 1699929109 | Cjs Enterprises, Inc. | Specialist | 482 Emily Dr, Clarksburg, WV 26301-5514 | 2008-11-11 |
| 1134371164 | Carol S Tenney | Specialist | 482 Emily Dr, Clarksburg, WV 26301-5514 | 2008-10-22 |
| 1881779759 | Jalal B. Fatemi | Specialist | 1 Medical Center Drive, Va Medical Center, Clarksburg, WV 26301 | 2006-10-26 |
| 1972601466 | Tommy Turner | Specialist | 1 Med Center Dr, Louis A. Johnson Vamc, Clarksburg, WV 26301-4155 | 2006-09-20 |
| Find all providers in CLARKSBURG | ||||
| City | CLARKSBURG |
| Zip Code | 20871 |
Please comment or provide details below to improve the information on PRESTIGE PHYSICAL THERAPY LLC.
| 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.