Active NPI
Kareen B.N. Newvillamor, PT
- Physical Therapist
- Gaithersburg, MD
National Provider Identifier
1548510654
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 24152
- Practice address
- 18749 N Frederick Ave
Ste I & J
Gaithersburg, MD 20879-3165 - Phone
- (301) 916-8540
- Fax
- (301) 916-8476
- NPI assigned
- Sep 17, 2012
- 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 | 24152 | MD | Primary |
Addresses
Primary practice location
18749 N Frederick Ave
Ste I & J
Gaithersburg, MD 20879-3165
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2222
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8825 - 0014 | Other | MD | CAREFIRST |
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 |
|---|---|---|---|
| 24152 | MD | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Active Physical Therapy Services, LLC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapist
- Laurel, MD
- NPI 1225217334
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1347840000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1528329600000",
"number": "1548510654",
"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": "630-296-2222",
"fax_number": "630-759-9510"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18749 N FREDERICK AVE",
"address_2": "STE I & J",
"city": "GAITHERSBURG",
"state": "MD",
"postal_code": "208793165",
"telephone_number": "301-916-8540",
"fax_number": "301-916-8476"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NEWVILLAMOR",
"first_name": "KAREEN",
"middle_name": "B.N.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-17",
"last_updated": "2018-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "24152",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAREFIRST",
"identifier": "8825 - 0014",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gaithersburg, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.