OrganizationActive
Charlestown
NPI 1417033259 · Physical Therapist · Baltimore, MD
Provider details
- NPI number
- 1417033259
- Entity type
- Organization
- Primary specialty
- Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Organization subpart
- No
- Authorized official
- Mary Wagner, Director(410) 600-2334
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
715 Maiden Choice Ln
Baltimore, MD 21228-5999
Phone: (410) 247-2340
Street-level locationGet directions
Mailing address
715 Maiden Choice Ln
Baltimore, MD 21228-5999
Other names (DBA / former)
- Doing business as
- Out Patient Rehab
Registry dates
- Enumerated
- 2006-10-27
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.