Individual provider Active NPI

Takiara Fowlkes

  • Physical Therapist
  • Pikesville, MD
National Provider Identifier
1780385575
Registry record updated Mar 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
29126 Issued in MD
Practice address
1848 Reisterstown Rd
Pikesville, MD 21208-1379
Phone
(443) 360-5527
Fax
(877) 353-0384
NPI assigned
Mar 17, 2023
Last updated
Mar 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2023

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 29126 MD Primary

Addresses

Primary practice location

1848 Reisterstown Rd
Pikesville, MD 21208-1379

Mailing address

6202 Gist Ave
Baltimore, MD 21215-3608
Phone (443) 360-5527

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20230501001214 MD Practitioner - Physical Therapist in Private Practice 8820453616 Reassigns benefits to 4 organizations
I20231214002323 DC Practitioner - Physical Therapist in Private Practice 8820453616 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maryland Luna Care Physical Therapy LLCGroup PAC ID 4284017419, 123 clinicians

Practice addresses (Care Compare)

5425 Wisconsin Ave
Suite 600
Chevy Chase, MD 20815-3588
Phone (866) 525-3175

9199 Reisterstown Rd
Suite 101B
Owings Mills, MD 21117-4513
Phone (443) 898-8160

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
29126MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Maryland Luna Care Physical Therapy LLC Physical Therapist CurrentSince Nov 6, 2023 Accepting new patients
Fall Prevention and Stroke Rehab Physician, LLC CurrentSince Aug 26, 2024 Accepting new patients
LHMG Physical Therapy, LLC Physical Therapist CurrentSince Oct 24, 2024 Accepting new patients
LHMG Physical Therapy, LLC Physical Therapist CurrentSince Oct 24, 2024 Accepting new patients
LHMG Physical Therapy, LLC Physical Therapist Current Accepting new patients
Lea's Place LLC Physical Therapist CurrentSince Apr 3, 2023 Accepting new patients
Medstar Health Physical Therapy at Home, LLC. Physical Therapist CurrentSince Dec 6, 2023 Accepting new patients
Medstar Health Physical Therapy at Home, LLC. Physical Therapist CurrentSince Dec 6, 2023 Accepting new patients
Fall Prevention and Stroke Rehab Physician, LLC PastSince Sep 1, 2024 Accepting new patients

Locations

5425 Wisconsin Ave
Ste 600
Chevy Chase, MD 20815
Phone (202) 223-3077

10980 Grantchester Way
Columbia, MD 21044
Phone (410) 772-6500

1106 Annapolis Rd
Ste 120
Odenton, MD 21113
Phone (410) 674-1650

9199 Reisterstown Rd
Ste 101B
Owings Mills, MD 21117
Phone (443) 543-6773

8109 Ritchie Hwy
Ste 600
Pasadena, MD 21122
Phone (410) 553-3515

1848 Reisterstown Rd
Pikesville, MD 21208
Phone (443) 360-5527

1848 Reisterstown Rd
Ste A
Pikesville, MD 21208
Phone (410) 292-8725

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24618/brand/1/csg/1/fhir/r4
  • Direct secure messaging: takiara.fowlkes.1@24618.direct.athenahealth.com

Organizations & group practices 9

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1679011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1780385575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6202 GIST AVE",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212153608",
            "telephone_number": "443-360-5527",
            "fax_number": "877-353-0384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1848 REISTERSTOWN RD",
            "city": "PIKESVILLE",
            "state": "MD",
            "postal_code": "212081379",
            "telephone_number": "443-360-5527",
            "fax_number": "877-353-0384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOWLKES",
        "first_name": "TAKIARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-17",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "29126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pikesville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2023; 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.