Individual provider Active NPI

Chloe Rachel Mermagen

  • Physical Therapist
  • Forest Hill, MD
National Provider Identifier
1487287546
Registry record updated Feb 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
27860 Issued in MD
Practice address
12 Newport Dr Ste a
Forest Hill, MD 21050-1758
Phone
(410) 838-9600
Fax
(410) 838-2511
NPI assigned
Feb 18, 2020
Last updated
Feb 19, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2020

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 27860 MD Primary

Addresses

Primary practice location

12 Newport Dr Ste a
Forest Hill, MD 21050-1758

Mailing address

PO Box 179
Forest Hill, MD 21050-0179
Phone (410) 795-7878

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200316001289 MD Practitioner - Physical Therapist in Private Practice 4284062753 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
27860MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Agape Physical Therapy & Sports Rehabilitation LP Physical Therapist CurrentSince Feb 24, 2020 Accepting new patients
Agape Physical Therapy & Sports Rehabilitation LP Physical Therapist PastSince Jan 12, 2020 Accepting new patients
Agape Physical Therapy & Sports Rehabilitation LP Physical Therapist PastSince Feb 27, 2022 Accepting new patients
Agape Physical Therapy & Sports Rehabilitation LP Physical Therapist PastSince Mar 17, 2024 Accepting new patients

Locations

2103 Laurel Bush Rd
Ste C
Bel Air, MD 21015
Phone (410) 569-2626

2304 E Churchville Rd
Bel Air, MD 21015
Phone (410) 734-6556

6 Barnes Corner Rd
Colora, MD 21917
Phone (410) 658-6616

3938 Conowingo Rd
Darlington, MD 21034
Phone (410) 457-2930

216 Mountain Rd
Fallston, MD 21047
Phone (410) 877-0222

12 Newport Dr
Ste A
Forest Hill, MD 21050
Phone (410) 838-6808

7468 Candlewood Rd
Ste H3
Hanover, MD 21076
Phone (410) 684-5642

1035 Pulaski Hwy
Ste 107A
Havre de Grace, MD 21078
Phone (443) 843-1003

1411 S Mountain Rd
Joppa, MD 21085
Phone (410) 676-6767

5301 Campbell Blvd
Nottingham, MD 21236
Phone (410) 933-9800

12 Mount Carmel Rd
Parkton, MD 21120
Phone (410) 357-0070

1388 Progress Way
Sykesville, MD 21784
Phone (410) 552-9996

4105 Norrisville Rd
Unit 7
White Hall, MD 21161
Phone (410) 692-2941

Organizations & group practices 4

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": "1581984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582070400000",
    "number": "1487287546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 179",
            "city": "FOREST HILL",
            "state": "MD",
            "postal_code": "210500179",
            "telephone_number": "410-795-7878",
            "fax_number": "410-795-7879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 NEWPORT DR STE A",
            "city": "FOREST HILL",
            "state": "MD",
            "postal_code": "210501758",
            "telephone_number": "410-838-9600",
            "fax_number": "410-838-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERMAGEN",
        "first_name": "CHLOE",
        "middle_name": "RACHEL",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-18",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "27860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hill, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.