Active NPI
Nicolas Smith
- Physical Therapist
- Glenn Dale, MD
National Provider Identifier
1396383709
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 12150 Annapolis Rd
Glenn Dale, MD 20769-9183 - Phone
- (301) 352-8370
- NPI assigned
- Dec 16, 2019
- Sex
- Male
- Sole proprietor
- Yes
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 | Primary |
Addresses
Primary practice location
12150 Annapolis Rd
Glenn Dale, MD 20769-9183
Mailing address
7213 N Alter St
Gwynn Oak, MD 21207-6421
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 27762 | MD | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Link Home Therapy Services of Maryland LLC | Physical Therapist | Current | Accepting new patients |
| Evidence Physical Therapy, LLC | Physical Therapist | Past | Accepting new patients |
Locations
2 Wisconsin Cir
Ste 700
Chevy Chase, MD 20815
Phone (202) 368-6820
180 Sylvan Ave
Ste 401
Englewood Cliffs, NJ 07632
Phone (347) 841-8943
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.
-
- Physical Therapist
- Chevy Chase, MD
- NPI 1912660416
-
- Physical Therapist
- Clinton, MD
- NPI 1982176988
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1576454400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1576454400000",
"number": "1396383709",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7213 N ALTER ST",
"city": "GWYNN OAK",
"state": "MD",
"postal_code": "212076421"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12150 ANNAPOLIS RD",
"city": "GLENN DALE",
"state": "MD",
"postal_code": "207699183",
"telephone_number": "301-352-8370"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "NICOLAS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-12-16",
"last_updated": "2019-12-16",
"certification_date": "2019-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glenn Dale, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.