Individual provider Active NPI

Kristin Lynn Mende, DPT

  • Physical Therapist
  • Ellicott City, MD
National Provider Identifier
1811007388
Registry record updated Jun 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
21193 Issued in MD
Practice address
4801 Dorsey Hall Dr
Suite 130
Ellicott City, MD 21042-7766
Phone
(443) 393-3788
Fax
(443) 378-3533
NPI assigned
Aug 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2016

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 21193 MD Primary

Addresses

Primary practice location

4801 Dorsey Hall Dr
Suite 130
Ellicott City, MD 21042-7766

Mailing address

6335 Wimbledon CT
Elkridge, MD 21075-5906
Phone (410) 733-3030

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
21193MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
David L. Higgins, M.D., P.C. Past Accepting new patients

Organizations & group practices 1

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467244800000",
    "number": "1811007388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6335 WIMBLEDON CT",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210755906",
            "telephone_number": "410-733-3030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 DORSEY HALL DR",
            "address_2": "SUITE 130",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210427766",
            "telephone_number": "443-393-3788",
            "fax_number": "443-378-3533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDE",
        "first_name": "KRISTIN",
        "middle_name": "LYNN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2016-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "21193",
            "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 Jun 30, 2016; 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.