Debora Kiessel Medlin, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

19741 Issued in MD

Practice address

6500 Thayer Ctr
Oakland, MD 21550-1116

Phone

(301) 334-1863

Fax

(301) 334-5835

NPI assigned

Mar 15, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

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": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352246400000",
    "number": "1235263146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6500 THAYER CTR",
            "city": "OAKLAND",
            "state": "MD",
            "postal_code": "215501116",
            "telephone_number": "301-334-1863",
            "fax_number": "301-334-5835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 THAYER CTR",
            "city": "OAKLAND",
            "state": "MD",
            "postal_code": "215501116",
            "telephone_number": "301-334-1863",
            "fax_number": "301-334-5835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDLIN",
        "first_name": "DEBORA",
        "middle_name": "KIESSEL",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2012-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "19741",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": "002043",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT016587",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "186300200",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Oakland, MD
• Providers in Oakland, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2012; 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.