Glen Burnie Physical Therapy & Sportscare, LLC
NPI 1396109708ActiveOrganization· Physical Therapist· Glen Burnie, MD
Physical Therapist in Glen Burnie, Maryland, registered in NPPES in April 2016. The authorized official on file is Tasheda Broughton, PESC, Manager, Credentialing.
Overview
| NPI | 1396109708 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Apr 12, 2016 |
| Last updated in NPPES | Feb 10, 2025 |
| Certified by provider | Feb 10, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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