Active NPI
Gwendolyn Redden, P.T.
- Physical Therapist
- Chesapeake Beach, MD
National Provider Identifier
1326401894
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 18424
- Practice address
- 8420 Bayside Rd
Chesapeake Beach, MD 20732 - Phone
- (443) 964-5656
- NPI assigned
- Apr 1, 2016
- 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 | 18424 | MD | Primary |
Addresses
Primary practice location
8420 Bayside Rd
Chesapeake Beach, MD 20732
Mailing address
PO Box 174
Owings, MD 20736-0174
Phone (301) 802-5310
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
Enrollment records 1
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
Practice addresses (Care Compare)
141 Thomas Johnson Dr
Suite 180
Frederick, MD 21702-4509
Phone (301) 620-7478
8420 Bayside Rd
Chesapeake Beach, MD 20732-3309
Phone (443) 964-5656
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18424 | MD | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Professional Sportscare & Rehab, LLC | Physical Therapist | Current | Accepting new patients |
Locations
2987 Plaza Dr
Dunkirk, MD 20754
Phone (443) 964-6348
Organizations & group practices 2
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.
-
- Clinic/Center
- Winchester, VA
- NPI 1033142294
MD, Physical Therapist
-
- Physical Therapist
- Westminster, MD
- NPI 1518951995
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1459468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589500800000",
"number": "1326401894",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 174",
"city": "OWINGS",
"state": "MD",
"postal_code": "207360174",
"telephone_number": "301-802-5310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8420 BAYSIDE RD",
"city": "CHESAPEAKE BEACH",
"state": "MD",
"postal_code": "20732",
"telephone_number": "443-964-5656"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REDDEN",
"first_name": "GWENDOLYN",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-01",
"last_updated": "2020-05-15",
"certification_date": "2020-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "18424",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chesapeake Beach, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2020; 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.