Individual provider Active NPI

Brittany Nicole Bull, DPT

  • Physical Therapist
  • Glen Burnie, MD
National Provider Identifier
1699020016
Registry record updated Jul 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
24126 Issued in MD
Practice address
1406B Crain Hwy S
Suite 107
Glen Burnie, MD 21061-4099
Phone
(410) 590-2334
Fax
(410) 590-2336
NPI assigned
Jul 23, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2012

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 24126 MD Primary

Addresses

Primary practice location

1406B Crain Hwy S
Suite 107
Glen Burnie, MD 21061-4099

Mailing address

1406B Crain Hwy S
Suite 107
Glen Burnie, MD 21061-4099
Phone (410) 590-2334

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20121008000007 MD Practitioner - Physical Therapist in Private Practice 4183873144 Reassigns benefits to 2 organizations
I20240819004450 DC Practitioner - Physical Therapist in Private Practice 4183873144 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Fox Rehab PT MD LLCGroup PAC ID 6709028822, 92 clinicians

Practice addresses (Care Compare)

11665 Doolittle Dr
Waldorf, MD 20602-2898
Phone (877) 407-3422

6451 N Charles St
Baltimore, MD 21212-1010
Phone (877) 407-3422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24126MDMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Red Canyon, LLC CurrentSince Dec 15, 2020 Accepting new patients
Red Canyon, LLC Physical Therapist CurrentSince Dec 15, 2020 Accepting new patients
Fox Rehabilitation Services LLC Physical Therapist CurrentSince Aug 1, 2024 Accepting new patients
Fox Rehab PT MD LLC Physical Therapist CurrentSince Aug 1, 2024 Accepting new patients
Red Canyon, LLC Physical Therapist Current Accepting new patients
Life Fitness Physical Therapy LLC Physical Therapist Past Accepting new patients

Locations

5500 Knoll North Dr
Ste 230
Columbia, MD 21045
Phone (410) 855-4855

801 Toll House Ave
Ste H3
Frederick, MD 21701
Phone (240) 575-9260

21 Crossroads Dr
Ste 330
Owings Mills, MD 21117
Phone (410) 356-6504

7402 York Rd
Ste 104
Towson, MD 21204
Phone (410) 560-3931

11665 Doolittle Dr
Waldorf, MD 20602
Phone (301) 638-4100

7 Carnegie Plz
Cherry Hill, NJ 08003

Organizations & group practices 6

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": "1343001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343001600000",
    "number": "1699020016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1406B CRAIN HWY S",
            "address_2": "SUITE 107",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210614099",
            "telephone_number": "410-590-2334",
            "fax_number": "410-590-2336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406B CRAIN HWY S",
            "address_2": "SUITE 107",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "210614099",
            "telephone_number": "410-590-2334",
            "fax_number": "410-590-2336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULL",
        "first_name": "BRITTANY",
        "middle_name": "NICOLE",
        "name_prefix": "Ms.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-23",
        "last_updated": "2012-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "24126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Burnie, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2012; 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.