Thomas L Baumgardner, PHD
Individual provider Active NPI Clinical Neuropsychologist · Towson, MD
NPI 1295944080 · NPPES record last updated Jan 7, 2021
Key facts
- NPI
- 1295944080
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Neuropsychologist 103G00000X
- License
- 03177 (MD)
- Practice address
- 8422 Bellona LN
Suite 205
Towson, MD 21204-2048 - Phone
- (410) 583-0011
- Fax
- (410) 583-0012
- NPI assigned
- May 21, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
- Opted out of Medicare
- Yes, effective Feb 10, 2017 through Feb 10, 2027
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 03177 | MD | MD | Clinical Neuropsychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Neuropsychologist | 103G00000X | 03177 | MD | Yes |
Addresses
Primary practice location
8422 Bellona LN
Suite 205
Towson, MD 21204-2048
Mailing address
8422 Bellona LN Ste 207
Towson, MD 21204-2057
Phone (410) 583-0011
Other providers in Towson, MD
- Donna Marie Batkis
- Ebony Battle
- Breona Batty
- Destinee Baughan
- Eileen Baughan
- Antonio Bautista
- Sunit Rashmikant Baxi
- Maria Baxter
- Bay Medical and Wellness Center
- Bayada Home Health Care, Inc.
All providers in Towson, MD · Clinical Neuropsychologist in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 7, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.