NPIMap

Individual provider Active NPI

Corey S Fraer, PTA

  • Physical Therapy Assistant
  • Pikesville, MD
National Provider Identifier
1437745650
Registry record updated Dec 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
A5186 Issued in MD
Practice address
9050 Iron Horse LN Apt 127
Pikesville, MD 21208-2159
Phone
(443) 617-1922
NPI assigned
Dec 13, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 225200000X A5186 MD Primary

Addresses

Primary practice location

9050 Iron Horse LN Apt 127
Pikesville, MD 21208-2159

Mailing address

9050 Iron Horse LN Apt 127
Pikesville, MD 21208-2159
Phone (443) 617-1922

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
A5186MDMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1607817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607817600000",
    "number": "1437745650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9050 IRON HORSE LN APT 127",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212082159",
            "telephone_number": "443-617-1922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9050 IRON HORSE LN APT 127",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212082159",
            "telephone_number": "443-617-1922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAER",
        "first_name": "COREY",
        "middle_name": "S",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-13",
        "last_updated": "2020-12-13",
        "certification_date": "2020-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "MD",
            "license": "A5186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pikesville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2020; 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.