Individual provider Active NPI

Ellen Anderson, DPT

  • Physical Therapist
  • Ellicott City, MD
National Provider Identifier
1689307076
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
29249 Issued in MD
Practice address
9501 Old Annapolis Rd Ste 125
Ellicott City, MD 21042-6355
Phone
(410) 997-1063
NPI assigned
Jul 5, 2022
Last updated
Nov 12, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X
Student in an Organized Health Care Education/Training Program 390200000X
Physical Therapist 225100000X 29249 MD Primary

Addresses

Primary practice location

9501 Old Annapolis Rd Ste 125
Ellicott City, MD 21042-6355

Mailing address

9501 Old Annapolis Rd Ste 125
Ellicott City, MD 21042-6355
Phone (410) 997-1063

Other practice location 1

2 Loveton Cir Ste G100
Sparks, MD 21152-9273
Phone (410) 472-2672

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
29249MDMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1656979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1689307076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9501 OLD ANNAPOLIS RD STE 125",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210426355",
            "telephone_number": "410-997-1063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9501 OLD ANNAPOLIS RD STE 125",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210426355",
            "telephone_number": "410-997-1063"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2 Loveton Cir Ste G100",
            "address_purpose": "LOCATION",
            "city": "Sparks",
            "state": "MD",
            "postal_code": "211529273",
            "country_code": "US",
            "telephone_number": "410-472-2672",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "ELLEN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-05",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "29249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; 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.