Michelle Black

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

19159 Issued in MD

Practice address

10995 Owings Mills Blvd Ste 210
Owings Mills, MD 21117-1030

Phone

(410) 654-2300

Fax

(410) 654-4561

NPI assigned

Sep 20, 2006

Last updated

Nov 2, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1989

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)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Maryland Sportscare & Rehab LLC

  dba Pivot Physical Therapy of Maryland

  • Physical Therapist
  • Westminster, MD
  • NPI 1518951995
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604275200000",
    "number": "1508964396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5454 WISCONSIN AVE",
            "address_2": "SUITE 1555",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "20815",
            "telephone_number": "301-951-8593",
            "fax_number": "301-951-8598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10995 OWINGS MILLS BLVD STE 210",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211171030",
            "telephone_number": "410-654-2300",
            "fax_number": "410-654-4561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "MICHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-20",
        "last_updated": "2020-11-02",
        "certification_date": "2020-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "DC",
            "license": "PT2843",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "19159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynnda R Bird, L.C.P.C.
• Debra Lynn Birenbaum, M.D.
• Tracy Chinita Bishop, FAMILY CRNP
• Andre Bisimwa
• BJ's Wholesale Club Inc.
• Blackstar Solutions LLC
• Merlene J. Blair-Brown, LCMFT
• Jacqueline Kester Blair, M.ED., LGMFT
• Andrea Bland
• Leslie Y Bland, PTA

• Physical Therapist in Owings Mills, MD
• Providers in Owings Mills, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2020; 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.