Nicole Tannahill, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

18663 Issued in MD

Practice address

900 East 33Rd St
Baltimore, MD 21218

Phone

(301) 540-6140

Fax

(301) 540-5190

NPI assigned

Oct 18, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Nicole Ketterer Former name

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Johns Hopkins Community Physicians, IncGroup PAC ID 8325943707, 764 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Johns Hopkins Community Physicians, Inc

  • Internal Medicine Physician
  • Baltimore, MD
  • NPI 1578598868
  Medicare reassignment Care Compare group NPD
• Johns Hopkins Community Physicians

  • Physical Medicine & Rehabilitation Physician
  • Baltimore, MD
  • NPI 1013738285
  NPD
• Johns Hopkins Community Physicians

  • Clinical Social Worker
  • Baltimore, MD
  • NPI 1356161806
  NPD

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

{
    "created_epoch": "1287360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1700196284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20410 CENTURY BLVD",
            "address_2": "NRH REGIONAL REHAB, SUITE 215",
            "city": "GERMANTOWN",
            "state": "MD",
            "postal_code": "20874",
            "telephone_number": "301-540-6140",
            "fax_number": "301-540-5190"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 EAST 33RD ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21218",
            "telephone_number": "301-540-6140",
            "fax_number": "301-540-5190"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNAHILL",
        "first_name": "NICOLE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-18",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "18663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "KETTERER",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Teresa Tang, MD
• Sarah Lei Del Pilar Tanguilig, R.N.
• Dharmesh Tank, MD
• Carol F Tankard, PHD
• Nicole Tanna
• Ellen Kay Tannen, LCPC
• Ayrowyn Tanner, CRNP
• Judith F. Tanner, CRNP
• Kayla Deshae Tanner
• Michele Tanner, CAC-AD

• Physical Therapist in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 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.