Individual provider Active NPI

Samuel Walter Allison

  • Physical Therapist
  • Nottingham, MD
National Provider Identifier
1457046591
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
29469 Issued in MD
Practice address
7629 Belair Rd
Nottingham, MD 21236-4003
Phone
(410) 870-2104
Fax
(410) 870-6896
NPI assigned
Apr 5, 2023
Last updated
Nov 19, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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 29469 MD Primary

Addresses

Primary practice location

7629 Belair Rd
Nottingham, MD 21236-4003

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925

Other practice location 1

7711 Quarterfield Rd Ste C2
Glen Burnie, MD 21061-4591
Phone (410) 487-6447

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230719000859 MD Practitioner - Physical Therapist in Private Practice 1254791486 Reassigns benefits to 4 organizations
I20230719001081 DC Practitioner - Physical Therapist in Private Practice 1254791486 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Pittsburgh School of Medicine, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maryland Sportscare and Rehab LLCGroup PAC ID 2860440427, 166 clinicians

Practice addresses (Care Compare)

7629 Belair Rd
Nottingham, MD 21236-4003
Phone (410) 870-2104

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
29469MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Ati Holdings, LLC Physical Therapist CurrentSince Aug 29, 2023 Accepting new patients
Glen Burnie Physical Therapy & Sportscare, LLC Physical Therapist CurrentSince Jun 12, 2023 Accepting new patients
Maryland Sportscare & Rehab LLC Physical Therapist CurrentSince Nov 19, 2024 Accepting new patients
Glen Burnie Physical Therapy & Sportscare, LLC Physical Therapist CurrentSince Jun 12, 2023 Accepting new patients
Maryland Sportscare & Rehab, LLC Physical Therapist CurrentSince Nov 19, 2024 Accepting new patients
Ati Holdings, LLC Physical Therapist CurrentSince Aug 29, 2023 Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

1510 Rock Spring Rd
Ste C
Forest Hill, MD 21050
Phone (410) 420-3619

141 Thomas Johnson Dr
Ste 180
Frederick, MD 21702
Phone (301) 620-7478

7711 Quarterfield Rd
Ste C2
Glen Burnie, MD 21061
Phone (410) 487-6447

14700 Baltimore Ave
Unit 106
Laurel, MD 20707
Phone (240) 754-2203

7629 Belair Rd
Nottingham, MD 21236
Phone (410) 870-2104

3708 Mountain Rd
Ste D
Pasadena, MD 21122
Phone (410) 255-4833

25 Main St
Ste A
Reisterstown, MD 21136
Phone (410) 833-8300

52 Rising Sun Town Ctr
Rising Sun, MD 21911
Phone (410) 658-0100

7 W Ridgely Rd
Ste A
Timonium, MD 21093
Phone (443) 274-5368

350 New Fidelity Ct
Garner, NC 27529
Phone (919) 373-2919

Organizations & group practices 6

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": "1680652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1457046591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7629 BELAIR RD",
            "city": "NOTTINGHAM",
            "state": "MD",
            "postal_code": "212364003",
            "telephone_number": "410-870-2104",
            "fax_number": "410-870-6896"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7711 Quarterfield Rd Ste C2",
            "address_purpose": "LOCATION",
            "city": "Glen Burnie",
            "state": "MD",
            "postal_code": "210614591",
            "country_code": "US",
            "telephone_number": "410-487-6447",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ALLISON",
        "first_name": "SAMUEL",
        "middle_name": "WALTER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-05",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "29469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nottingham, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; 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.