Individual provider Active NPI

David Allan Brown, P.T.

  • Physical Therapist
  • Edgewater, MD
National Provider Identifier
1437200110
Registry record updated Jun 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
16655 Issued in MD
Practice address
3179 Braverton St.
Suite 201
Edgewater, MD 21037
Phone
(410) 956-4308
NPI assigned
Jan 16, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2016

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 16655 MD Primary

Addresses

Primary practice location

3179 Braverton St.
Suite 201
Edgewater, MD 21037

Mailing address

3179 Braverton St
Ste 201
Edgewater, MD 21037-2667
Phone (410) 829-7684

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110608000557 MD Practitioner - Physical Therapist in Private Practice 8224024120 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

202 Coursevall Dr
Suite 111And112
Centreville, MD 21617-2804
Phone (410) 758-0018

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16655MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Bayside Physical Therapy & Sports Rehabilitation Limited Partnership Physical Therapist CurrentSince Dec 21, 2010 Accepting new patients
Bayside Physical Therpay and Sports Rehabilitation, Inc Physical Therapist PastSince Dec 21, 2010 Accepting new patients

Locations

202 Coursevall Dr
Ste 111
Centreville, MD 21617
Phone (410) 758-0018

3179 Braverton St
Ste 201
Edgewater, MD 21037
Phone (410) 956-4308

155 Sallitt Dr
Ste B
Stevensville, MD 21666
Phone (410) 604-2162

155 Log Canoe Cir
Stevensville, MD 21666
Phone (410) 604-0226

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.

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466121600000",
    "number": "1437200110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3179 BRAVERTON ST",
            "address_2": "STE 201",
            "city": "EDGEWATER",
            "state": "MD",
            "postal_code": "210372667",
            "telephone_number": "410-829-7684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3179 BRAVERTON ST.",
            "address_2": "SUITE 201",
            "city": "EDGEWATER",
            "state": "MD",
            "postal_code": "21037",
            "telephone_number": "410-956-4308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "DAVID",
        "middle_name": "ALLAN",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2016-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "16655",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edgewater, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2016; 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.