Active NPI
Caroline Delceta Black, PT
- Military Health Care Provider
- Bethesda, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Military Health Care Provider
- License
- 17660
- Practice address
- National Naval Medical Center Rockville Pike
Bethesda, MD 20850 - Phone
- (301) 295-4880
- NPI assigned
- Apr 27, 2007
- Reactivated
- May 23, 2023
- Last updated
- May 23, 2023
- 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 |
|---|---|---|---|---|
| Military Health Care Provider | 171000000X | 17660 | MD | Primary |
Addresses
Primary practice location
National Naval Medical Center Rockville Pike
Bethesda, MD 20850
Mailing address
13116 Ardennes Ave
Rockville, MD 20851-2332
Phone (301) 540-1886
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC, VA, MD
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
17051 Oakmont Ave
Suite D
Gaithersburg, MD 20877-4142
Phone (240) 543-6572
9885 Greenbelt Rd
Lanham, MD 20706-2302
Phone (877) 407-3422
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17660 | MD | MD | EEG Specialist/Technologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fox Rehab PT MD LLC | Current | Accepting new patients | |
| Fox Rehabilitation Services LLC | Current | Accepting new patients | |
| Healthy Checkups LLC | Current | Accepting new patients | |
| Functional Pathways Preferred of Tennessee LLC | Current | Accepting new patients | |
| Excel Rehabilitation, PLLC | Current | Accepting new patients | |
| Capitol Orthopaedics and Rehabilitation, LLC | Past | Accepting new patients |
Locations
17051 Oakmont Ave
Ste B
Gaithersburg, MD 20877
Phone (240) 543-6572
17051 Oakmont Ave
Ste D
Gaithersburg, MD 20877
Phone (240) 543-6572
11665 Doolittle Dr
Waldorf, MD 20602
Phone (301) 638-4100
10133 Sherrill Blvd
Ste 200
Knoxville, TN 37932
Phone (865) 392-2847
10521 Rosehaven St
Ste LL150
Fairfax, VA 22030
Phone (703) 383-1616
3317 Ocean Shore Ave
Virginia Beach, VA 23451
Phone (757) 232-3179
Organizations & group practices 7
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.
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- NPI 1588901847
-
- Physical Therapist
- Gaithersburg, MD
- NPI 1669747598
-
- Orthopaedic Surgery Physician
- Rockville, MD
- NPI 1457561847
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684800000000",
"number": "1346460698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13116 ARDENNES AVE",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "208512332",
"telephone_number": "301-540-1886"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "NATIONAL NAVAL MEDICAL CENTER ROCKVILLE PIKE",
"city": "BETHESDA",
"state": "MD",
"postal_code": "20850",
"telephone_number": "301-295-4880"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLACK",
"first_name": "CAROLINE",
"middle_name": "DELCETA",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-27",
"last_updated": "2023-05-23",
"certification_date": "2023-05-23",
"deactivation_date": "2023-05-04",
"reactivation_date": "2023-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "171000000X",
"taxonomy_group": "",
"desc": "Military Health Care Provider",
"state": "MD",
"license": "17660",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bethesda, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; 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.