Individual provider Active NPI

Kerstin Waltz, OT

  • Occupational Therapist
  • Ellicott City, MD
National Provider Identifier
1780990150
Registry record updated Dec 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
05519 Issued in MD
Practice address
9501 Old Annapolis Rd Ste 125
Ellicott City, MD 21042-6355
Phone
(410) 997-1063
Fax
(410) 997-1408
NPI assigned
Aug 24, 2010
Last updated
Dec 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 05519 MD Primary

Addresses

Primary practice location

9501 Old Annapolis Rd Ste 125
Ellicott City, MD 21042-6355

Mailing address

9501 Old Annapolis Rd Ste 125
Ellicott City, MD 21042-6355
Phone (410) 997-1063

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
05519MDMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
National Rehabilitation Hospital, Inc. Occupational Therapist CurrentSince Dec 31, 2023 Accepting new patients
National Rehabilitation Hospital, Inc. Occupational Therapist PastSince Dec 24, 2023 Accepting new patients

Locations

9501 Old Annapolis Rd
Ste 125
Ellicott City, MD 21042
Phone (410) 997-1063

20410 Century Blvd
Ste 215
Germantown, MD 20874
Phone (301) 916-8500

Organizations & group practices 2

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": "1282608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702857600000",
    "number": "1780990150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9501 OLD ANNAPOLIS RD STE 125",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210426355",
            "telephone_number": "410-997-1063",
            "fax_number": "410-997-1408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9501 OLD ANNAPOLIS RD STE 125",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210426355",
            "telephone_number": "410-997-1063",
            "fax_number": "410-997-1408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALTZ",
        "first_name": "KERSTIN",
        "name_prefix": "Mrs.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-24",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MD",
            "license": "05519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.