Individual provider Active NPI

Christopher T Gardner, D.P.T.

  • Physical Therapist
  • Berlin, MD
National Provider Identifier
1386909794
Registry record updated Sep 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
23853 Issued in MD
Practice address
11204 Racetrack Rd
101
Berlin, MD 21811-3367
Phone
(410) 208-1525
Fax
(410) 208-1527
NPI assigned
Jul 11, 2012
Last updated
Sep 11, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2013

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 23853 MD Primary

Addresses

Primary practice location

11204 Racetrack Rd
101
Berlin, MD 21811-3367

Mailing address

11204 Racetrack Rd
101
Berlin, MD 21811-3367
Phone (410) 208-1525

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120802000474 MD Practitioner - Physical Therapist in Private Practice 5890941173 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7845 Oakwood Rd
Glen Burnie, MD 21061-4280
Phone (410) 969-7580

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
23853MDMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Atlantic Rehab, Inc Physical Therapist Current Accepting new patients
Apex Therapy Solutions, LLC Physical Therapist CurrentSince Jun 26, 2019 Accepting new patients
Luminis Health Medical Group, LLC Past Accepting new patients

Locations

7845 Oakwood Rd
Ste 300
Glen Burnie, MD 21061
Phone (410) 760-5638

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1378857600000",
    "number": "1386909794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11204 RACETRACK RD",
            "address_2": "101",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218113367",
            "telephone_number": "410-208-1525",
            "fax_number": "410-208-1527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11204 RACETRACK RD",
            "address_2": "101",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218113367",
            "telephone_number": "410-208-1525",
            "fax_number": "410-208-1527"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "CHRISTOPHER",
        "middle_name": "T",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-11",
        "last_updated": "2013-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "23853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berlin, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2013; 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.