Individual provider Active NPI

Courtney Frederick, DPT

  • Physical Therapist
  • Silver Spring, MD
National Provider Identifier
1669840732
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
25658 Issued in MD
Practice address
10301 Georgia Ave
Suite 200
Silver Spring, MD 20902-5020
Phone
(301) 681-7880
Fax
(301) 500-2715
NPI assigned
Sep 8, 2015
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT024665 PA
Physical Therapist 225100000X 25658 MD Primary

Addresses

Primary practice location

10301 Georgia Ave
Suite 200
Silver Spring, MD 20902-5020

Mailing address

PO Box 356
Burtonsville, MD 20866-0356
Phone (301) 421-1125

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170913003116 PA Practitioner - Physical Therapist in Private Practice 4587965322 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clarion Rehabilitation and Aquatic Therapy LLCGroup PAC ID 0345582326, 3 clinicians

Practice addresses (Care Compare)

499 Mayfield Rd
Ofc 134
Clarion, PA 16214-6101
Phone (814) 226-1356

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25658MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Drayer Physical Therapy Institute LLC Physical Therapist CurrentSince Sep 12, 2017 Accepting new patients
Drayer Physical Therapy Institute LLC Physical Therapist CurrentSince Sep 12, 2017 Accepting new patients
Drayer Physical Therapy Institute LLC Physical Therapist Current Accepting new patients
Clarion Rehabilitation and Aquatic Therapy LLC Physical Therapist CurrentSince Sep 24, 2019 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

18 Sportsman Dr
Ste 10
Clarion, PA 16214
Phone (814) 226-1355

499 Mayfield Rd
Ofc 134
Clarion, PA 16214
Phone (814) 226-1355

499 Mayfield Rd
Ste 134
Clarion, PA 16214
Phone (814) 226-1355

873 Beaver Dr
Dubois, PA 15801
Phone (814) 503-8361

8205 Presidents Dr
#2
Hummelstown, PA 17036
Phone (717) 803-2560

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": "1441670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1669840732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 356",
            "city": "BURTONSVILLE",
            "state": "MD",
            "postal_code": "208660356",
            "telephone_number": "301-421-1125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10301 GEORGIA AVE",
            "address_2": "SUITE 200",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209025020",
            "telephone_number": "301-681-7880",
            "fax_number": "301-500-2715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "COURTNEY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-08",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT024665",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "25658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.