Individual provider Active NPI

Cecilia Esther Campos, DPT

  • Physical Therapist
  • Glenn Dale, MD
National Provider Identifier
1144888694
Registry record updated May 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
27486 Issued in MD
Practice address
12150 Annapolis Rd Ste 201
Glenn Dale, MD 20769-9183
Phone
(301) 352-8370
NPI assigned
May 30, 2019
Last updated
May 30, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 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 27486 MD Primary

Addresses

Primary practice location

12150 Annapolis Rd Ste 201
Glenn Dale, MD 20769-9183

Mailing address

5764 Stevens Forest Rd Apt 218
Columbia, MD 21045-3720
Phone (443) 812-2554

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200520002029 MD Practitioner - Physical Therapist in Private Practice 1759616667 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27486MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
McNerney & Associates, P.a. Physical Therapist CurrentSince Mar 5, 2020 Accepting new patients

Locations

5024 Dorsey Hall Dr
Ste 103
Ellicott City, MD 21042
Phone (410) 740-1047

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": "1559174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559174400000",
    "number": "1144888694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5764 STEVENS FOREST RD APT 218",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210453720",
            "telephone_number": "443-812-2554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12150 ANNAPOLIS RD STE 201",
            "city": "GLENN DALE",
            "state": "MD",
            "postal_code": "207699183",
            "telephone_number": "301-352-8370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAMPOS",
        "first_name": "CECILIA",
        "middle_name": "ESTHER",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-30",
        "last_updated": "2019-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "27486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenn Dale, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.