Active NPI
Nicole M Vivlamore, DPT
- Physical Therapist
- Bowie, MD
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 24084
- Practice address
- 6842 Race Track Rd Ste B
Bowie, MD 20715-3011 - Phone
- (240) 544-0200
- Fax
- (301) 464-1053
- NPI assigned
- Sep 28, 2012
- Last updated
- Dec 8, 2022
- Sex
- Female
- Sole proprietor
- No
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 | 24084 | MD | Primary |
Addresses
Primary practice location
6842 Race Track Rd Ste B
Bowie, MD 20715-3011
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (866) 370-8206
Other practice location 1
2000 Medical Pkwy
Suite 101
Annapolis, MD 21401-3742
Phone (410) 295-8900 ext. 3318
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC, MD
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2327 Forest Dr
Suite D
Annapolis, MD 21401-3865
Phone (443) 782-7243
6842 Race Track Rd B
Bowie, MD 20715-3011
Phone (240) 544-0200
Merit-based Incentive Payment System (MIPS)
- Final score
- 86.05 of 100
- Quality
- 89.12
- Improvement activities
- 40
- Cost
- 73.46
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24084 | MD | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Professional Sportscare & Rehab, LLC | Physical Therapist | Current | Accepting new patients |
| Ati Holdings, LLC | Physical Therapist | Current | Accepting new patients |
| Ati Holdings, LLC | Physical Therapist | Current | Accepting new patients |
Locations
790 Remington Blvd
Bolingbrook, IL 60440
4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001
2327 Forest Dr
Ste D
Annapolis, MD 21401
Phone (443) 782-7243
6842 Race Track Rd
#B
Bowie, MD 20715
Phone (240) 544-0200
2987 Plaza Dr
Dunkirk, MD 20754
Phone (443) 964-6348
9 Lee Airpark Dr
Ste 400
Edgewater, MD 21037
Phone (443) 607-1469
1510 Rock Spring Rd
Ste C
Forest Hill, MD 21050
Phone (410) 420-3619
2389 Brandermill Blvd
Ste 103
Gambrills, MD 21054
Phone (410) 774-9821
2634 Brandermill Blvd
Gambrills, MD 21054
Phone (410) 721-7201
12913 Coastal Hwy
Ocean City, MD 21842
Phone (410) 213-7878
52 Rising Sun Town Ctr
Rising Sun, MD 21911
Phone (410) 658-0100
11271 New Hampshire Ave
Silver Spring, MD 20904
Phone (240) 485-1280
1600 Wilson Blvd
Ste 102
Arlington, VA 22209
Phone (301) 464-4500
Organizations & group practices 3
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.
-
dba ATI Physical Therapy
- Physical Therapy Clinic/Center
- Rising Sun, MD
- NPI 1396781050
DC, Physical Therapist
-
dba Pivot Physical Therapy of Metro DC
- Clinic/Center
- Winchester, VA
- NPI 1033142294
DC, MD, Physical Therapist
-
- Durable Medical Equipment & Medical Supplies
- King of Prussia, PA
- NPI 1750194460
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348790400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670457600000",
"number": "1457602567",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 REMINGTON BLVD",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604404909",
"telephone_number": "866-370-8206",
"fax_number": "517-435-3670"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6842 RACE TRACK RD STE B",
"city": "BOWIE",
"state": "MD",
"postal_code": "207153011",
"telephone_number": "240-544-0200",
"fax_number": "301-464-1053"
}
],
"practiceLocations": [
{
"address_1": "2000 Medical Pkwy",
"address_2": "SUITE 101",
"address_purpose": "LOCATION",
"city": "Annapolis",
"state": "MD",
"postal_code": "214013742",
"country_code": "US",
"telephone_number": "410-295-8900 x3318",
"fax_number": "410-280-4701",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VIVLAMORE",
"first_name": "NICOLE",
"middle_name": "M",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-28",
"last_updated": "2022-12-08",
"certification_date": "2022-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "24084",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bowie, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2022; 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.