Active NPI
Kelly D Sykes, PT
- Physical Therapist
- Columbia, MD
National Provider Identifier
1164555793
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 18546
- Practice address
- 10200 Old Columbia Rd Ste C
Columbia, MD 21046-2364 - Phone
- (410) 290-4480
- Fax
- (855) 300-3999
- NPI assigned
- Mar 13, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 18546 | MD | Primary |
Addresses
Primary practice location
10200 Old Columbia Rd Ste C
Columbia, MD 21046-2364
Mailing address
10200 Old Columbia Rd Ste C
Columbia, MD 21046-2364
Phone (410) 290-4480
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110104000036 | MD | Practitioner - Physical Therapist in Private Practice | 7719175082 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sports and Orthopedic Therapy Services LLC | Physical Therapist | Past | Accepting new patients |
| Robert C Grossman & Assoc PA | Physical Therapist | Past | Accepting new patients |
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 and National Provider Directory roles.
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- Kensington, MD
- NPI 1245304518
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725235200000",
"number": "1164555793",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10200 OLD COLUMBIA RD STE C",
"city": "COLUMBIA",
"state": "MD",
"postal_code": "210462364",
"telephone_number": "410-290-4480",
"fax_number": "855-300-3999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10200 OLD COLUMBIA RD STE C",
"city": "COLUMBIA",
"state": "MD",
"postal_code": "210462364",
"telephone_number": "410-290-4480",
"fax_number": "855-300-3999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SYKES",
"first_name": "KELLY",
"middle_name": "D",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-13",
"last_updated": "2024-09-02",
"certification_date": "2024-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "18546",
"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 2, 2024; 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.