Healthcare Provider Details

I. General information

NPI: 1326897398
Provider Name (Legal Business Name): NATIONAL REHABILITATION HOSPITAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2024
Last Update Date: 10/10/2024
Certification Date: 10/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2523 GWYNNS FALLS PKWY STE 131 ATTN: CSU PHYSICAL EDUCATION BLDG SPORTS MEDICINE
BALTIMORE MD
21216-3201
US

IV. Provider business mailing address

102 IRVING ST NW ATTN: MHPT PAYOR ENROLLMENT
WASHINGTON DC
20010-2921
US

V. Phone/Fax

Practice location:
  • Phone: 410-230-7830
  • Fax: 410-230-7831
Mailing address:
  • Phone: 301-540-6140
  • Fax: 301-540-5190

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOHN DAVID ROCKWOOD
Title or Position: PRESIDENT
Credential:
Phone: 301-540-6140