Individual provider Active NPI

Glendon Nick

  • Orthopedic Physical Therapist
  • Elkridge, MD
National Provider Identifier
1003214412
Registry record updated Dec 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
25314 Issued in MD
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

Updated by the provider on Dec 17, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

Enrollment IDStateProvider typePAC IDDetails
I20211117000953 DC Practitioner - Physical Therapist in Private Practice 6305235102 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25314MDMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
LHMG Physical Therapy, LLC CurrentSince Nov 8, 2021 Accepting new patients
LHMG Physical Therapy, LLC CurrentSince Nov 8, 2021 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.

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.

Verify at the official NPI Registry.