Holly Brown
Individual provider Active NPI Occupational Therapist · Chillum, MD
NPI 1669034799 · NPPES record last updated Jun 28, 2019
Key facts
- NPI
- 1669034799
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- License
- 417050 (MD)
- Practice address
- 5702 Sargent Rd
Chillum, MD 20782-2321 - Phone
- (301) 853-7370
- NPI assigned
- Jun 28, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Occupational Therapist in Private Practice
- Education
- Other, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Fox Rehab OT MD LLC
Practice addresses (Care Compare)
11665 Doolittle Dr
Waldorf, MD 20602-2898
Phone (877) 407-3422
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in DC, MD
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251201000394 | DC | Practitioner - Occupational Therapist in Private Practice | 5698268522 | Reassigns benefits to 1 organization |
| I20251201000800 | MD | Practitioner - Occupational Therapist in Private Practice | 5698268522 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 417050 | MD | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fox Rehab OT MD LLC | Occupational Therapist | Current |
Accepting new patients |
| Fox Rehabilitation Services LLC | Occupational Therapist | Current |
Accepting new patients |
Locations
11665 Doolittle Dr
Waldorf, MD 20602
Phone (301) 638-4100
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 417050 | MD | Yes |
Addresses
Primary practice location
5702 Sargent Rd
Chillum, MD 20782-2321
Mailing address
10817 Bellehaven Blvd
Damascus, MD 20872-2201
Other providers in Chillum, MD
All providers in Chillum, MD · Occupational Therapist in Maryland
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 28, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.