Individual provider Active NPI

Ukonnaya Bigelow, DPT

  • Physical Therapist
  • Laurel, MD
National Provider Identifier
1407497712
Registry record updated Oct 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
20245 Issued in MD
Practice address
14409 Greenview Dr Ste 102
Laurel, MD 20708-4213
Phone
(301) 498-8100
Fax
(301) 498-0009
NPI assigned
Oct 8, 2019
Last updated
Oct 8, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2019

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 20245 MD Primary

Addresses

Primary practice location

14409 Greenview Dr Ste 102
Laurel, MD 20708-4213

Mailing address

PO Box 500
Brookeville, MD 20833-0500

Other identifiers 1

IdentifierTypeStateIssuer
20245OtherMDSTATE DEPARTMENT OF HEALTH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
20245MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Associated Professional Rehabilitation Services, Inc. Physical Therapist PastSince Oct 13, 2019 Accepting new patients
Rehabilitation Services, Inc. Physical Therapist PastSince Oct 13, 2019 Accepting new patients

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, 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": "1570492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570492800000",
    "number": "1407497712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 500",
            "city": "BROOKEVILLE",
            "state": "MD",
            "postal_code": "208330500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14409 GREENVIEW DR STE 102",
            "city": "LAUREL",
            "state": "MD",
            "postal_code": "207084213",
            "telephone_number": "301-498-8100",
            "fax_number": "301-498-0009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIGELOW",
        "first_name": "UKONNAYA",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-10-08",
        "last_updated": "2019-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "20245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE DEPARTMENT OF HEALTH",
            "identifier": "20245",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Laurel, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.