Individual provider Active NPI

Nicole J Brown, PT, DPT

  • Physical Therapist
  • Aberdeen, MD
National Provider Identifier
1689061772
Registry record updated Jul 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
25408 Issued in MD
Practice address
998 Hospitality Way Ste 101
Aberdeen, MD 21001-1757
Phone
(410) 273-9776
Fax
(410) 273-9777
NPI assigned
Apr 16, 2015
Last updated
Jul 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 25408 MD Primary

Addresses

Primary practice location

998 Hospitality Way Ste 101
Aberdeen, MD 21001-1757

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150518000191 MD Practitioner - Physical Therapist in Private Practice 9436479359 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ati Holdings, LLCGroup PAC ID 9537112719, 440 clinicians

Practice addresses (Care Compare)

1321 Riverside Pkwy
Suite A2
Belcamp, MD 21017-3405
Phone (443) 760-3971

Merit-based Incentive Payment System (MIPS)

Final score
86.05 of 100Reported as group
Quality
89.12
Improvement activities
40
Cost
73.46

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
25408MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mady and Mules, PA CurrentSince Sep 7, 2022 Accepting new patients
Ati Holdings, LLC Physical Therapist CurrentSince Oct 12, 2022 Accepting new patients
Ati Holdings, LLC Physical Therapist CurrentSince Oct 12, 2022 Accepting new patients
Mady and Mules, PA PastSince Sep 7, 2022 Accepting new patients
Life Fitness Physical Therapy LLC Physical Therapist Past Accepting new patients

Locations

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001

7672 Belair Rd
Baltimore, MD 21236
Phone (410) 633-6450

1321 Riverside Pkwy
Ste A2
Belcamp, MD 21017
Phone (443) 760-3971

1510 Rock Spring Rd
Ste C
Forest Hill, MD 21050
Phone (410) 420-3619

1212 York Rd
Ste C101
Lutherville Timonium, MD 21093
Phone (410) 321-0377

52 Rising Sun Town Ctr
Rising Sun, MD 21911
Phone (410) 658-0100

Organizations & group practices 5

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": "1429142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719964800000",
    "number": "1689061772",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "998 HOSPITALITY WAY STE 101",
            "city": "ABERDEEN",
            "state": "MD",
            "postal_code": "210011757",
            "telephone_number": "410-273-9776",
            "fax_number": "410-273-9777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "NICOLE",
        "middle_name": "J",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-16",
        "last_updated": "2024-07-03",
        "certification_date": "2024-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "25408",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aberdeen, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2024; 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.