Individual provider Active NPI

Kathleen Anne Mineweaser, PTA

  • Physical Therapy Assistant
  • Gambrills, MD
National Provider Identifier
1548373699
Registry record updated Mar 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
A2611 Issued in MD
Practice address
2634 Brandermill Blvd
Gambrills, MD 21054-1651
Phone
(410) 721-7201
Fax
(410) 721-7580
NPI assigned
Aug 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X A2611 MD Primary

Addresses

Primary practice location

2634 Brandermill Blvd
Gambrills, MD 21054-1651

Mailing address

117 Orville Road
Baltimore, MD 21221
Phone (410) 686-2270

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
A2611MDMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205280000000",
    "number": "1548373699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 ORVILLE ROAD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21221",
            "telephone_number": "410-686-2270",
            "fax_number": "410-686-5447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2634 BRANDERMILL BLVD",
            "city": "GAMBRILLS",
            "state": "MD",
            "postal_code": "210541651",
            "telephone_number": "410-721-7201",
            "fax_number": "410-721-7580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINEWEASER",
        "first_name": "KATHLEEN",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-15",
        "last_updated": "2008-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MD",
            "license": "A2611",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gambrills, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.