Active NPI
Kimberly Denise Hanson, DPT
- Physical Therapist
- Ellicott City, MD
National Provider Identifier
1821328212
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 22921
- Practice address
- 9501 Old Annapolis Rd
Dorsey Hall Medical Center, Suite 125
Ellicott City, MD 21042-6314 - Phone
- (410) 997-1063
- Fax
- (410) 997-1408
- NPI assigned
- Jan 6, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 22921 | MD | Primary |
Addresses
Primary practice location
9501 Old Annapolis Rd
Dorsey Hall Medical Center, Suite 125
Ellicott City, MD 21042-6314
Mailing address
20410 Century Blvd
Suite 215
Germantown, MD 20874-1186
Phone (301) 540-6140
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 182132821 | Medicaid | MD | |
| 182132821 | Other | MD | MEDICARE |
Other names 1
- Ms. Kimberly Hanson Borro
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Professional Sportscare, LLC | Physical Therapist | 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.
-
- Physical Therapist
- Gambrills, MD
- NPI 1508892761
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1262736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405555200000",
"number": "1821328212",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20410 CENTURY BLVD",
"address_2": "SUITE 215",
"city": "GERMANTOWN",
"state": "MD",
"postal_code": "208741186",
"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": "9501 OLD ANNAPOLIS RD",
"address_2": "DORSEY HALL MEDICAL CENTER, SUITE 125",
"city": "ELLICOTT CITY",
"state": "MD",
"postal_code": "210426314",
"telephone_number": "410-997-1063",
"fax_number": "410-997-1408"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANSON",
"first_name": "KIMBERLY",
"middle_name": "DENISE",
"name_prefix": "Mrs.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-01-06",
"last_updated": "2014-07-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "22921",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "182132821",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "182132821",
"state": "MD"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "KIMBERLY",
"last_name": "BORRO",
"middle_name": "HANSON",
"prefix": "MS.",
"credential": "DPT",
"code": "1",
"type": "Former Name"
}
]
}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 Jul 17, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.