Individual provider Active NPI

Roger Hall, P.T.

  • Geriatric Physical Therapist
  • Towson, MD
National Provider Identifier
1053450734
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Physical TherapistTaxonomy code 2251G0304X
License
19852 Issued in MD
Practice address
7401 Osler Dr
Suite 110
Towson, MD 21204-7673
Phone
(410) 296-8888
NPI assigned
Feb 6, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Physical Therapist 2251G0304X 19852 MD Primary
Geriatric Physical Therapist 2251G0304X 2305203397 VA

Addresses

Primary practice location

7401 Osler Dr
Suite 110
Towson, MD 21204-7673

Mailing address

11979 Arlington Mill Rd
Union Bridge, MD 21791-7707
Phone (301) 898-0393

Other identifiers 1

IdentifierTypeStateIssuer
620633-01OtherMDBC BS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260521000599 NY Practitioner - Physical Therapist in Private Practice 9032133285 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

254 Getzville Rd
Buffalo, NY 14226-3542

4 Medical Park Dr
Suite B
Pomona, NY 10970-3539

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2305203397VAMDGeriatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Amber Hill Physical Therapy, Inc. Geriatrics CurrentSince Jan 28, 2013 Accepting new patients

Locations

9701 New Church St
Ste 3
Damascus, MD 20872
Phone (301) 253-0896

187 Thomas Johnson Dr
Frederick, MD 21702
Phone (301) 378-9421

187 Thomas Johnson Dr
Ste 6
Frederick, MD 21702
Phone (301) 663-1157

3500 Campus Dr
Ste 101
Frederick, MD 21704
Phone (301) 473-5945

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053450734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11979 ARLINGTON MILL RD",
            "city": "UNION BRIDGE",
            "state": "MD",
            "postal_code": "217917707",
            "telephone_number": "301-898-0393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7401 OSLER DR",
            "address_2": "SUITE 110",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212047673",
            "telephone_number": "410-296-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "ROGER",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "MD",
            "license": "19852",
            "primary": true
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "VA",
            "license": "2305203397",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS",
            "identifier": "620633-01",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Towson, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.