Active NPI
Glendon Nick
- Orthopedic Physical Therapist
- Elkridge, MD
National Provider Identifier
1003214412
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopedic Physical Therapist
- License
- 25314
- Practice address
- 7829 Grassy Garth
Elkridge, MD 21075-6139 - Phone
- (410) 799-2089
- NPI assigned
- Dec 17, 2014
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopedic Physical Therapist | 2251X0800X | 25314 | MD | Primary |
Addresses
Primary practice location
7829 Grassy Garth
Elkridge, MD 21075-6139
Mailing address
7829 Grassy Garth
Elkridge, MD 21075-6139
Phone (410) 799-2089
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 25314 | MD | MD | Orthopedic Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| LHMG Physical Therapy, LLC | Current | Accepting new patients | |
| LHMG Physical Therapy, LLC | Current | Accepting new patients | |
| LHMG Physical Therapy, LLC | Orthopedic | Current | Accepting new patients |
Locations
4175 N Hanson Ct
Ste 301
Bowie, MD 20716
Phone (301) 805-0190
6836 Race Track Rd
Bowie, MD 20715
Phone (301) 805-7004
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- Annapolis, MD
- NPI 1134763212
-
- Physical Therapist
- Upper Marlboro, MD
- NPI 1982214490
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1418774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1418774400000",
"number": "1003214412",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7829 GRASSY GARTH",
"city": "ELKRIDGE",
"state": "MD",
"postal_code": "210756139",
"telephone_number": "410-799-2089"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7829 GRASSY GARTH",
"city": "ELKRIDGE",
"state": "MD",
"postal_code": "210756139",
"telephone_number": "410-799-2089"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NICK",
"first_name": "GLENDON",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-12-17",
"last_updated": "2014-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "2251X0800X",
"taxonomy_group": "",
"desc": "Physical Therapist, Orthopedic",
"state": "MD",
"license": "25314",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Elkridge, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.