Individual provider Active NPI

Allison Nicole Funk, ATC

  • Physical Therapist
  • Crofton, MD
National Provider Identifier
1073169942
Registry record updated Jul 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
29037 Issued in MD
Practice address
1756 Crofton Pkwy
Crofton, MD 21114-2334
Phone
(240) 678-4219
NPI assigned
Aug 15, 2019
Last updated
Jul 18, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 29037 MD Primary
Athletic Trainer 2255A2300X

Addresses

Primary practice location

1756 Crofton Pkwy
Crofton, MD 21114-2334

Mailing address

1756 Crofton Pkwy
Crofton, MD 21114-2334
Phone (240) 678-4219

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220727001391 DC Practitioner - Physical Therapist in Private Practice 8729460597 Reassigns benefits to 1 organization
I20220727001618 MD Practitioner - Physical Therapist in Private Practice 8729460597 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Privia Medical Group, LLCGroup PAC ID 4385682061, 1,522 clinicians

Practice addresses (Care Compare)

133 Defense Hwy
Annapolis, MD 21401-7015

551 Baltimore Annapolis Blvd
Suite D
Severna Park, MD 21146-3809
Phone (443) 441-0676

551 E Baltimore Annapolis Blvd
Severna Park, MD 21146-3809
Phone (443) 441-0676

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Privia Medical Group, LLC CurrentSince Oct 1, 2023 Accepting new patients
Professional Sportscare & Rehab, LLC Physical Therapist CurrentSince Jul 19, 2022 Accepting new patients
Privia Medical Group, LLC CurrentSince Oct 1, 2023 Accepting new patients
Felice Physical Therapy Physical Therapist CurrentSince Apr 17, 2023 Accepting new patients

Locations

133 Defense Hwy
Ste 112
Annapolis, MD 21401
Phone (410) 573-0140

10 Light St
Baltimore, MD 21202
Phone (410) 202-8581

2987 Plaza Dr
Dunkirk, MD 20754
Phone (443) 964-6348

551 Baltimore Annapolis Blvd
#D
Severna Park, MD 21146
Phone (443) 441-0676

11350 Pembrooke Sq
Ste 304
Waldorf, MD 20603
Phone (301) 856-2810

1600 Wilson Blvd
Ste 102
Arlington, VA 22209
Phone (301) 464-4500

950 N Glebe Rd
Ste 700
Arlington, VA 22203
Phone (484) 228-1065

Interoperability endpoints

  • Direct secure messaging: allison.funk.1@8042.direct.athenahealth.com

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, 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": "1565827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658102400000",
    "number": "1073169942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1756 CROFTON PKWY",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211142334",
            "telephone_number": "240-678-4219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1756 CROFTON PKWY",
            "city": "CROFTON",
            "state": "MD",
            "postal_code": "211142334",
            "telephone_number": "240-678-4219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUNK",
        "first_name": "ALLISON",
        "middle_name": "NICOLE",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-15",
        "last_updated": "2022-07-18",
        "certification_date": "2022-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "29037",
            "primary": true
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crofton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2022; 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.