Individual provider Active NPI

Keiocsha Barnes

  • Physical Therapist
  • Waldorf, MD
National Provider Identifier
1699444232
Registry record updated Feb 20, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
30755 Issued in MD
Practice address
2875 Crain Hwy Ste 6
Waldorf, MD 20601-2841
Phone
(301) 859-3304
NPI assigned
Sep 8, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2026

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 30755 MD Primary
Behavior Technician 106S00000X

Addresses

Primary practice location

2875 Crain Hwy Ste 6
Waldorf, MD 20601-2841

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925

Other practice location 1

8440 Pitstop ct NW
Concord, NC 28027
Phone (704) 960-1729

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20260305000874 MD Practitioner - Physical Therapist in Private Practice 7517449853 Reassigns benefits to 2 organizations
I20260305001044 DC Practitioner - Physical Therapist in Private Practice 7517449853 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Sportscare and Rehab LLCGroup PAC ID 9335137363, 103 clinicians
Maryland Sportscare and Rehab LLCGroup PAC ID 2860440427, 166 clinicians

Practice addresses (Care Compare)

2875 Crain Hwy
Suite 6
Waldorf, MD 20601-2807
Phone (301) 859-3304

2875 Crain Hwy
Suite 6
Waldorf, MD 20601-2841
Phone (301) 859-3304

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30755MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Professional Sportscare & Rehab, LLC Physical Therapist CurrentSince Feb 23, 2026 Accepting new patients
Compleat Rehab & Sports Therapy Center PastSince Sep 12, 2021 Accepting new patients

Locations

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

2875 Crain Hwy
Ste 6
Waldorf, MD 20601
Phone (301) 859-3304

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": "1631059200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771545600000",
    "number": "1699444232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2875 CRAIN HWY STE 6",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206012841",
            "telephone_number": "301-859-3304"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8440 Pitstop ct NW",
            "address_purpose": "LOCATION",
            "city": "Concord",
            "state": "NC",
            "postal_code": "28027",
            "country_code": "US",
            "telephone_number": "704-960-1729",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARNES",
        "first_name": "KEIOCSHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-08",
        "last_updated": "2026-02-20",
        "certification_date": "2026-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "30755",
            "primary": true
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waldorf, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2026; 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.