Individual provider Active NPI

Gerald Hoadley, P.T., D.P.T.

  • Physical Therapist
  • Forest Hill, MD
National Provider Identifier
1689690117
Registry record updated Feb 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
21002 Issued in MD
Practice address
12 Newport Dr
Suite a
Forest Hill, MD 21050-1758
Phone
(410) 838-6808
Fax
(410) 838-2511
NPI assigned
Jul 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2008

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 21002 MD Primary

Addresses

Primary practice location

12 Newport Dr
Suite a
Forest Hill, MD 21050-1758

Mailing address

PO Box 179
Forest Hill, MD 21050-0179
Phone (410) 838-6808

Other identifiers 1

IdentifierTypeStateIssuer
621770OtherMDBCBS MD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040423000984 MD Practitioner - Physical Therapist in Private Practice 9133115108 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Carroll Sports Rehabilitation and Physical Therapy, LLC Physical Therapist Past Accepting new patients
Agape Physical Therapy & Sports Rehabilitation LP Physical Therapist Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202947200000",
    "number": "1689690117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 179",
            "city": "FOREST HILL",
            "state": "MD",
            "postal_code": "210500179",
            "telephone_number": "410-838-6808",
            "fax_number": "410-838-2511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 NEWPORT DR",
            "address_2": "SUITE A",
            "city": "FOREST HILL",
            "state": "MD",
            "postal_code": "210501758",
            "telephone_number": "410-838-6808",
            "fax_number": "410-838-2511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOADLEY",
        "first_name": "GERALD",
        "credential": "P.T., D.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2008-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "21002",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MD",
            "identifier": "621770",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hill, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.