Performance Spine & Rehabilitation INC
Chiropractor in Sparks, MD. Organization (NPI-2).
NPI number1255538005
StatusActive
Last updated in NPPESMay 13, 2024
Details
- NPI
- 1255538005
- Entity type
- Organization (NPI-2)
- Legal business name
- Performance Spine & Rehabilitation INC
- Organization subpart
- No
- Enumeration date
- Jun 27, 2007
- Certification date
- May 13, 2024
- Last updated
- May 13, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - CLINIC/GROUP PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 111N00000X | Chiropractor | 02151 | MD | Yes |
Practice location
10 Fila WaySuite 208
Sparks, MD 21152-9452
Phone 410-472-9625 · Fax 410-472-9627
Mailing address
10 Fila WaySuite 208
Sparks, MD 21152-9452
Phone 410-472-9625 · Fax 410-472-9627
Authorized official
Matthew Joseph Lepito
Ceo
4104729625
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