Individual provider Active NPI

Nicole Renee Garner, PT

  • Physical Therapist
  • Hyattsville, MD
National Provider Identifier
1023257144
Registry record updated Oct 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
22786 Issued in MD
Practice address
3311 Toledo Ter Ste A1
Hyattsville, MD 20782-4136
Phone
(301) 853-0093
NPI assigned
Feb 12, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2021

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 22786 MD Primary

Addresses

Primary practice location

3311 Toledo Ter Ste A1
Hyattsville, MD 20782-4136

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2222

Other identifiers 1

IdentifierTypeStateIssuer
22786OtherMARYLAND LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20091119000619 MD Practitioner - Physical Therapist in Private Practice 7416096011 Reassigns benefits to 4 organizations
I20141016000084 DC Practitioner - Physical Therapist in Private Practice 7416096011 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7130 Minstrel Way
Ll110
Columbia, MD 21045-5261
Phone (240) 841-2639

9500 Medical Ctr Dr
Suite 300
Largo, MD 20774-3714
Phone (301) 263-3605

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22786MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ati Holdings, LLC Physical Therapist CurrentSince Feb 1, 2018 Accepting new patients
DCPT PLLC Physical Therapist CurrentSince Oct 1, 2020 Accepting new patients
Ati Holdings, LLC Physical Therapist CurrentSince Feb 1, 2018 Accepting new patients
Cam Physical Therapy and Wellness Services LLC Physical Therapist CurrentSince May 10, 2021 Accepting new patients

Locations

1301 Pennsylvania Ave SE
Ste 100
Washington, DC 20003
Phone (202) 455-8644

4001 Brandywine St NW
Ste 101
Washington, DC 20016
Phone (202) 430-5421

1301 Pennsylvania Ave SE
Washington, DC 20003
Phone (202) 335-7968

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

6931 Arlington Rd
Ste C
Bethesda, MD 20814
Phone (301) 246-2244

14300 Gallant Fox Ln
Ste 115
Bowie, MD 20715
Phone (301) 853-0093

4740 Cherry Hill Rd
College Park, MD 20740
Phone (240) 965-0999

10440 Little Patuxent Pkwy
Ste 300
Columbia, MD 21044
Phone (240) 203-4457

1510 Rock Spring Rd
Ste C
Forest Hill, MD 21050
Phone (410) 420-3619

12150 Annapolis Rd
Ste 305
Glenn Dale, MD 20769
Phone (301) 805-9500

3311 Toledo Ter
Ste A1
Hyattsville, MD 20782
Phone (301) 853-0093

14205 Park Center Dr
Ste 204
Laurel, MD 20707
Phone (301) 853-0093

52 Rising Sun Town Ctr
Rising Sun, MD 21911
Phone (410) 658-0100

11271 New Hampshire Ave
Silver Spring, MD 20904
Phone (240) 485-1280

3828 International Dr
Silver Spring, MD 20906
Phone (301) 853-0093

2730 University Blvd W
Ste 802
Wheaton, MD 20902
Phone (301) 853-0093

Organizations & group practices 5

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": "1234396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634860800000",
    "number": "1023257144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2222",
            "fax_number": "630-759-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3311 TOLEDO TER STE A1",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207824136",
            "telephone_number": "301-853-0093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARNER",
        "first_name": "NICOLE",
        "middle_name": "RENEE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-02-12",
        "last_updated": "2021-10-22",
        "certification_date": "2021-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "22786",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARYLAND LICENSE NUMBER",
            "identifier": "22786",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyattsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2021; 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.