Active NPI
Colleen Marisa Howard, DPT
- Physical Therapist
- Edgewood, MD
National Provider Identifier
1457784100
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 24655
- Practice address
- 1401 Pulaski Hwy Ste F
Edgewood, MD 21040-1398 - Phone
- (443) 372-5300
- Fax
- (443) 372-5810
- NPI assigned
- Aug 16, 2013
- 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 | 24655 | MD | Primary |
Addresses
Primary practice location
1401 Pulaski Hwy Ste F
Edgewood, MD 21040-1398
Mailing address
6 Buttrick CT
#204
Timonium, MD 21093-1920
Phone (570) 721-1152
Other names 1
- Colleen Marisa Potter
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24655 | MD | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Procare Physical Therapy Inc | Physical Therapist | Past | Accepting new patients |
| Life Fitness Physical Therapy LLC | Physical Therapist | Past | 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 and National Provider Directory roles.
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- NPI 1285882670
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- Physical Therapist
- Towanda, PA
- NPI 1003876319
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1397520000000",
"number": "1457784100",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 BUTTRICK CT",
"address_2": "#204",
"city": "TIMONIUM",
"state": "MD",
"postal_code": "210931920",
"telephone_number": "570-721-1152"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1401 PULASKI HWY STE F",
"city": "EDGEWOOD",
"state": "MD",
"postal_code": "210401398",
"telephone_number": "443-372-5300",
"fax_number": "443-372-5810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOWARD",
"first_name": "COLLEEN",
"middle_name": "MARISA",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-08-16",
"last_updated": "2014-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "24655",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "COLLEEN",
"last_name": "POTTER",
"middle_name": "MARISA",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Edgewood, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.