Active NPI
Benjamin Leon Gilbert, PHYSICAL THERAPIST
- Physical Therapist
- Kensington, MD
National Provider Identifier
1841341310
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 26662
- Practice address
- 4017 Everett St
Kensington, MD 20895-3821 - Phone
- (727) 686-3574
- NPI assigned
- Jan 13, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT14792 | FL | |
| Physical Therapist | 225100000X | PT872233 | DC | |
| Physical Therapist | 225100000X | 26662 | MD | Primary |
Addresses
Primary practice location
4017 Everett St
Kensington, MD 20895-3821
Mailing address
4017 Everett St
Kensington, MD 20895-3821
Phone (727) 686-3574
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in DC
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26662 | MD | MD | Critical Care Pharmacist |
| PT14792 | FL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Legacy Healthcare Services Inc | Physical Therapist | Current | Accepting new patients |
| Legacy Healthcare Services, Inc | Physical Therapist | Current | Accepting new patients |
Locations
110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300
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 and National Provider Directory roles.
-
- Physical Therapist
- Washington, DC
- NPI 1255750030
-
- Physical Therapist
- Cary, NC
- NPI 1225879489
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168646400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1590451200000",
"number": "1841341310",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4017 EVERETT ST",
"city": "KENSINGTON",
"state": "MD",
"postal_code": "208953821",
"telephone_number": "727-686-3574"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4017 EVERETT ST",
"city": "KENSINGTON",
"state": "MD",
"postal_code": "208953821",
"telephone_number": "727-686-3574"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GILBERT",
"first_name": "BENJAMIN",
"middle_name": "LEON",
"credential": "PHYSICAL THERAPIST",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-13",
"last_updated": "2020-05-26",
"certification_date": "2020-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT14792",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "DC",
"license": "PT872233",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "26662",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Kensington, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.