Individual provider Active NPI

Chantelle M Lamour, DPT, PT

  • Physical Therapist
  • Columbia, MD
National Provider Identifier
1063893691
Registry record updated Sep 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
24909 Issued in MD
Practice address
7080 Deepage Dr
Columbia, MD 21045-5348
Phone
(410) 381-7000
Fax
(410) 381-3779
NPI assigned
Jun 9, 2015
Last updated
Sep 18, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2019

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 24909 MD Primary

Addresses

Primary practice location

7080 Deepage Dr
Columbia, MD 21045-5348

Mailing address

PO Box 356
Burtonsville, MD 20866-0356
Phone (014) 211-1253

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24909MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
4 Oaks Physical Therapy, LLC. Physical Therapist CurrentSince May 1, 2023 Accepting new patients

Locations

10632 Little Patuxent Pkwy
Ste 123
Columbia, MD 21044
Phone (443) 917-2973

2000 Century Plz
Columbia, MD 21044
Phone (410) 740-4802

1413 Madison Park Dr
Ste 100
Glen Burnie, MD 21061
Phone (443) 583-3757

Organizations & group practices 1

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": "1433808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568764800000",
    "number": "1063893691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 356",
            "city": "BURTONSVILLE",
            "state": "MD",
            "postal_code": "208660356",
            "telephone_number": "014-211-1253",
            "fax_number": "301-500-2175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7080 DEEPAGE DR",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210455348",
            "telephone_number": "410-381-7000",
            "fax_number": "410-381-3779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAMOUR",
        "first_name": "CHANTELLE",
        "middle_name": "M",
        "credential": "DPT, PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-09",
        "last_updated": "2019-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "24909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2019; 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.