Individual provider Active NPI

Steven Gilliam, PT, DPT

  • Physical Therapist
  • Bowie, MD
National Provider Identifier
1104605047
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
30082 Issued in MD
Practice address
4175 N Hanson CT Ste 301
Bowie, MD 20716-3186
Phone
(443) 481-1140
NPI assigned
Sep 28, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X MD
Physical Therapist 225100000X 30082 MD Primary

Addresses

Primary practice location

4175 N Hanson CT Ste 301
Bowie, MD 20716-3186

Mailing address

4175 N Hanson CT Ste 301
Bowie, MD 20716-3186
Phone (443) 481-1140

Other practice location 1

740 Maryland Route 3 S
Gambrills, MD 21054-1318
Phone (443) 645-3162

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20241003001176 DC Practitioner - Physical Therapist in Private Practice 0244761088 Reassigns benefits to 1 organization
I20241004000506 MD Practitioner - Physical Therapist in Private Practice 0244761088 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Maryland School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
LHMG Physical Therapy, LLCGroup PAC ID 3870893738, 101 clinicians

Practice addresses (Care Compare)

6836 Race Track Rd
Bowie, MD 20715-3011
Phone (301) 805-7004

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
LHMG Physical Therapy, LLC Physical Therapist CurrentSince Sep 9, 2024 Accepting new patients
LHMG Physical Therapy, LLC Physical Therapist CurrentSince Sep 9, 2024 Accepting new patients
LHMG Physical Therapy, LLC Physical Therapist Current Accepting new patients

Locations

2000 Medical Pkwy
Ste 409
Annapolis, MD 21401
Phone (443) 481-5136

4175 N Hanson Ct
Ste 304
Bowie, MD 20716
Phone (301) 352-4007

4175 N Hanson Ct
Ste 301
Bowie, MD 20716
Phone (301) 805-0190

6836 Race Track Rd
Bowie, MD 20715
Phone (301) 805-7004

28438 Marlboro Ave
Easton, MD 21601
Phone (410) 820-7270

8638 Veterans Hwy
Fl 1
Millersville, MD 21108
Phone (410) 729-4508

8109 Ritchie Hwy
Ste 600
Pasadena, MD 21122
Phone (410) 553-3515

Organizations & group practices 3

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": "1695859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1104605047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4175 N HANSON CT STE 301",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207163186",
            "telephone_number": "443-481-1140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4175 N HANSON CT STE 301",
            "city": "BOWIE",
            "state": "MD",
            "postal_code": "207163186",
            "telephone_number": "443-481-1140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "740 Maryland Route 3 S",
            "address_purpose": "LOCATION",
            "city": "Gambrills",
            "state": "MD",
            "postal_code": "210541318",
            "country_code": "US",
            "telephone_number": "443-645-3162",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GILLIAM",
        "first_name": "STEVEN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-28",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MD",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "30082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2024; 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.