Renee Bouroult Strother, P.T.A

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

A2299 Issued in MD

Practice address

200 Scott Ave
Glen Burnie, MD 21060-7760

Phone

(410) 222-6942

Fax

(410) 222-6943

NPI assigned

Apr 26, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1225258627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "603 YORKTOWN MANOR CT",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214095767",
            "telephone_number": "410-757-6890",
            "fax_number": "410-757-0550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 SCOTT AVE",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210607760",
            "telephone_number": "410-222-6942",
            "fax_number": "410-222-6943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STROTHER",
        "first_name": "RENEE",
        "middle_name": "BOUROULT",
        "name_prefix": "Mrs.",
        "credential": "P.T.A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MD",
            "license": "A2299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Assistant in Glen Burnie, MD
• Providers in Glen Burnie, MD by specialty
• Physical Therapy Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.