Individual provider Active NPI

Patrena Lynette Caldwell, P.T

  • Physical Therapist
  • Gwynn Oak, MD
National Provider Identifier
1306917463
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
18087 Issued in MD
Practice address
9 Summerset CT
Gwynn Oak, MD 21207-8108
Phone
(410) 484-1001
NPI assigned
Nov 12, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 18087 MD Primary

Addresses

Primary practice location

9 Summerset CT
Gwynn Oak, MD 21207-8108

Mailing address

9 Summerset CT
Gwynn Oak, MD 21207-8108

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040721000556 MD Practitioner - Physical Therapist in Private Practice 4082694054 Reassigns benefits to 3 organizations
I20240308001388 TX Practitioner - Physical Therapist in Private Practice 4082694054 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Salus Capital IncGroup PAC ID 6103131198, 25 clinicians

Practice addresses (Care Compare)

1020 Saint Paul St
Baltimore, MD 21202-2606
Phone (410) 529-0348

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ati Holdings, LLC Physical Therapist CurrentSince Feb 21, 2022 Accepting new patients
Ati Holdings, LLC Physical Therapist CurrentSince Feb 21, 2022 Accepting new patients
Dilkon Medical Center CurrentSince Aug 22, 2024 Accepting new patients
Winslow Indian Health Care Center, Inc Current Accepting new patients
Salus Capital Inc Physical Therapist CurrentSince Jun 1, 2019 Accepting new patients
Winslow Indian Health Care Center, Inc CurrentSince Aug 22, 2024 Accepting new patients
RTD Medical Center, Inc. Physical Therapist Past Accepting new patients
R&S Home Care, Inc Past Accepting new patients
Atlantic Medical Services, LLC Physical Therapist Past Accepting new patients

Locations

500 Indiana Ave
Winslow, AZ 86047

1527 N Park Dr
Winslow, AZ 86047

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

1020 Saint Paul St
Baltimore, MD 21202
Phone (410) 529-0348

1510 Rock Spring Rd
Ste C
Forest Hill, MD 21050
Phone (410) 420-3619

52 Rising Sun Town Ctr
Rising Sun, MD 21911
Phone (410) 658-0100

1409 S Salisbury Blvd
Unit Cd
Salisbury, MD 21801
Phone (667) 330-1061

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1163289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306917463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 SUMMERSET CT",
            "city": "GWYNN OAK",
            "state": "MD",
            "postal_code": "212078108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 SUMMERSET CT",
            "city": "GWYNN OAK",
            "state": "MD",
            "postal_code": "212078108",
            "telephone_number": "410-484-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDWELL",
        "first_name": "PATRENA",
        "middle_name": "LYNETTE",
        "name_prefix": "Miss",
        "credential": "P.T",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "18087",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gwynn Oak, MD

Sources for this page

  • 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.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.