Active NPI
Pamela Lynn Dwan, PT
- Physical Therapist
- Bel Air, MD
National Provider Identifier
1265996201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 19957
- Practice address
- 2225 Old Emmorton Rd Ste 210
Bel Air, MD 21015-6123 - Phone
- (410) 515-4900
- NPI assigned
- Jan 23, 2019
- Sex
- Female
- 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 | 19957 | MD | Primary |
Addresses
Primary practice location
2225 Old Emmorton Rd Ste 210
Bel Air, MD 21015-6123
Mailing address
1712 Charmuth Rd
Lutherville, MD 21093-5737
Phone (410) 560-6872
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19957 | MD | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Maryland Therapy Network, Inc | Physical Therapist | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Speech-Language Pathologist
- Bel Air, MD
- NPI 1770611394
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1548201600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1548201600000",
"number": "1265996201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1712 CHARMUTH RD",
"city": "LUTHERVILLE",
"state": "MD",
"postal_code": "210935737",
"telephone_number": "410-560-6872"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2225 OLD EMMORTON RD STE 210",
"city": "BEL AIR",
"state": "MD",
"postal_code": "210156123",
"telephone_number": "410-515-4900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DWAN",
"first_name": "PAMELA",
"middle_name": "LYNN",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-01-23",
"last_updated": "2019-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "19957",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bel Air, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.