Individual provider Active NPI

Brenda Rutledge, PT

  • Physical Therapist
  • Ellicott City, MD
National Provider Identifier
1861449183
Registry record updated Feb 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
5236 Talbots LNDG
Ellicott City, MD 21043-6845
Phone
(443) 445-3733
NPI assigned
May 30, 2006
Last updated
Feb 4, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 19648 MD
Physical Therapist 225100000X MD Primary

Addresses

Primary practice location

5236 Talbots LNDG
Ellicott City, MD 21043-6845

Mailing address

5236 Talbots Landing
Ellicott City, MD 21043
Phone (443) 445-3733

Other practice location 1

200 Hospital Dr Ste 400
Glen Burnie, MD 21061-5893
Phone (410) 768-5555

Other practice location 2

7556 Teague Rd Ste 400
Hanover, MD 21076-1213
Phone (410) 799-4994

Other names 1

  • Ms. Brenda Cavanaugh Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070816000120 MD Practitioner - Physical Therapist in Private Practice 7517059801 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Centers for Advanced Orthopaedics, LLC CurrentSince Jun 19, 2017 Accepting new patients
Centers for Advanced Orthopaedics, LLC Current Accepting new patients
Centers for Advanced Orthopaedics, LLC CurrentSince Jun 19, 2017 Accepting new patients
Physical Therapy Dynamics, Inc Physical Therapist PastSince Jan 1, 1990 Accepting new patients

Locations

10710 Charter Dr
Ste 300
Columbia, MD 21044
Phone 4106441880450

86 Thomas Johnson Ct
Frederick, MD 21702
Phone (301) 607-0444

200 Hospital Dr
Glen Burnie, MD 21061
Phone (410) 768-5555

200 Hospital Dr
Ste 400
Glen Burnie, MD 21061
Phone (410) 760-0093

7556 Teague Rd
Ste 400
Hanover, MD 21076
Phone (410) 768-5555

Organizations & group practices 4

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": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1549238400000",
    "number": "1861449183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5236 TALBOTS LANDING",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "21043",
            "telephone_number": "443-445-3733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5236 TALBOTS LNDG",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "210436845",
            "telephone_number": "443-445-3733"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Hospital Dr Ste 400",
            "address_purpose": "LOCATION",
            "city": "Glen Burnie",
            "state": "MD",
            "postal_code": "210615893",
            "country_code": "US",
            "telephone_number": "410-768-5555",
            "fax_number": "888-313-5209",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "7556 Teague Rd Ste 400",
            "address_purpose": "LOCATION",
            "city": "Hanover",
            "state": "MD",
            "postal_code": "210761213",
            "country_code": "US",
            "telephone_number": "410-799-4994",
            "fax_number": "410-799-1044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUTLEDGE",
        "first_name": "BRENDA",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-30",
        "last_updated": "2019-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "19648",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRENDA",
            "last_name": "CAVANAUGH",
            "prefix": "MS.",
            "credential": "PT",
            "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 Feb 4, 2019; 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.

Verify at the official NPI Registry.