Kevin Wrenn, D.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

19681 Issued in MD

Practice address

3179 Braverton St
Suite 201
Edgewater, MD 21037-2665

Phone

(410) 956-4308

NPI assigned

Nov 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Bayside Physical Therpay and Sports Rehabilitation, Inc

  • Occupational Therapist
  • Edgewater, MD
  • NPI 1114096880

  Physical Therapist

  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466121600000",
    "number": "1043381981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3179 BRAVERTON ST",
            "address_2": "STE 201",
            "city": "EDGEWATER",
            "state": "MD",
            "postal_code": "210372667",
            "telephone_number": "410-695-1325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3179 BRAVERTON ST",
            "address_2": "SUITE 201",
            "city": "EDGEWATER",
            "state": "MD",
            "postal_code": "210372665",
            "telephone_number": "410-956-4308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRENN",
        "first_name": "KEVIN",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-13",
        "last_updated": "2016-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "19681",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carrie A. Williams, PT
• Phillip Williams, PHARMD
• Karon R Wilson Jr., LCPC
• Katouri Wilson, LCSW-C
• Jason Worobey, FNP-BC
• Patricia A Wright, PT
• Heather Zivkovich, LMT, BCTMB
• Patricia Ann Zwald
• Janise Zygmont

• Physical Therapist in Edgewater, MD
• Providers in Edgewater, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.