Individual provider Active NPI

Darien Antoine Mellerson, DPT

  • Physical Therapist
  • Hanover, MD
National Provider Identifier
1003241316
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
24625 Issued in MD
Practice address
7556 Teague Rd Ste 400
Hanover, MD 21076-1213
Phone
(410) 799-4994
Fax
(410) 799-1044
NPI assigned
Sep 5, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 24625 MD Primary

Addresses

Primary practice location

7556 Teague Rd Ste 400
Hanover, MD 21076-1213

Mailing address

7556 Teague Rd Ste 400
Hanover, MD 21076-1213
Phone (410) 799-4994

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140122000087 MD Practitioner - Physical Therapist in Private Practice 8921236936 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

10710 Charter Dr
Suite 300
Columbia, MD 21044-3260
Phone (410) 644-1880

200 Hospital Dr
Glen Burnie, MD 21061-5884
Phone (410) 768-5555

86 Thomas Johnson CT
Frederick, MD 21702-4348
Phone (301) 694-8311

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24625MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Centers for Advanced Orthopaedics, LLC Physical Therapist CurrentSince Nov 1, 2013 Accepting new patients
Centers for Advanced Orthopaedics, LLC Current Accepting new patients
Centers for Advanced Orthopaedics, LLC CurrentSince Nov 1, 2013 Accepting new patients
Orthopaedic Associates of Central Maryland, PA Past Accepting new patients

Locations

10710 Charter Dr
Ste 300
Columbia, MD 21044
Phone 4106441880450

86 Thomas Johnson Ct
Frederick, MD 21702
Phone (301) 607-0444

200 Hospital Dr
Ste 400
Glen Burnie, MD 21061
Phone (410) 760-0093

200 Hospital Dr
Glen Burnie, MD 21061
Phone (410) 768-5555

7556 Teague Rd
Ste 400
Hanover, MD 21076
Phone (410) 768-5555

Organizations & group practices 4

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": "1378339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1003241316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7556 TEAGUE RD STE 400",
            "city": "HANOVER",
            "state": "MD",
            "postal_code": "210761213",
            "telephone_number": "410-799-4994",
            "fax_number": "410-799-1044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7556 TEAGUE RD STE 400",
            "city": "HANOVER",
            "state": "MD",
            "postal_code": "210761213",
            "telephone_number": "410-799-4994",
            "fax_number": "410-799-1044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLERSON",
        "first_name": "DARIEN",
        "middle_name": "ANTOINE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-05",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "24625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hanover, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.