Individual provider Active NPI

Charles Breeding

  • Physical Therapist
  • Denton, MD
National Provider Identifier
1245875814
Registry record updated Jan 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
27742 Issued in MD
Practice address
1140 Blades Farm Rd Ste 201
Denton, MD 21629-3489
Phone
(410) 479-3300
NPI assigned
Nov 7, 2019
Last updated
Jan 28, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2020

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 27742 MD Primary

Addresses

Primary practice location

1140 Blades Farm Rd Ste 201
Denton, MD 21629-3489

Mailing address

4004 Main St
Grasonville, MD 21638-1252
Phone (410) 924-0623

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191203001201 MD Practitioner - Physical Therapist in Private Practice 7517390677 Reassigns benefits to 1 organization
I20191203001411 DC Practitioner - Physical Therapist in Private Practice 7517390677 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
LHMG Physical Therapy, LLC Physical Therapist CurrentSince Nov 4, 2019 Accepting new patients
LHMG Physical Therapy, LLC Physical Therapist CurrentSince Nov 4, 2019 Accepting new patients
LHMG Physical Therapy, LLC Physical Therapist Current Accepting new patients
LHMG Physical Therapy, LLC Physical Therapist CurrentSince Nov 4, 2019 Accepting new patients
Shore Health System, Inc Past Accepting new patients

Locations

161 Jennifer Rd
Ste A
Annapolis, MD 21401

2000 Medical Pkwy
Ste 404
Annapolis, MD 21401

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

1106 Annapolis Rd
Ste 120
Odenton, MD 21113
Phone (410) 674-1650

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

Organizations & group practices 5

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": "1573084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580169600000",
    "number": "1245875814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4004 MAIN ST",
            "city": "GRASONVILLE",
            "state": "MD",
            "postal_code": "216381252",
            "telephone_number": "410-924-0623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 BLADES FARM RD STE 201",
            "city": "DENTON",
            "state": "MD",
            "postal_code": "216293489",
            "telephone_number": "410-479-3300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREEDING",
        "first_name": "CHARLES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-07",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "27742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denton, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; 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.