Active NPI
Nicole Angela Sergeant
- Physical Therapist
- Landover, MD
National Provider Identifier
1831410877
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT871045
- Practice address
- 504 Tailgate Ter
Landover, MD 20785-4796 - Phone
- (917) 771-6007
- NPI assigned
- Jun 14, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT871045 | DC | Primary |
| Physical Therapist | 225100000X | 22911 | MD |
Addresses
Primary practice location
504 Tailgate Ter
Landover, MD 20785-4796
Mailing address
504 Tailgate Ter
Landover, MD 20785-4796
Phone (917) 771-6007
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT871045 | DC | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1276473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1276473600000",
"number": "1831410877",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "504 TAILGATE TER",
"city": "LANDOVER",
"state": "MD",
"postal_code": "207854796",
"telephone_number": "917-771-6007"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "504 TAILGATE TER",
"city": "LANDOVER",
"state": "MD",
"postal_code": "207854796",
"telephone_number": "917-771-6007"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SERGEANT",
"first_name": "NICOLE",
"middle_name": "ANGELA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-06-14",
"last_updated": "2010-06-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "DC",
"license": "PT871045",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "22911",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Landover, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.