Individual provider Active NPI

Charity Wong

  • Physical Therapist
  • Columbia, MD
National Provider Identifier
1871362681
Registry record updated Jan 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
29715 Issued in MD
Practice address
5500 Knoll North Dr Ste 150
Columbia, MD 21045-2476
Phone
(443) 542-0062
NPI assigned
Dec 21, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2024

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 29715 MD Primary

Addresses

Primary practice location

5500 Knoll North Dr Ste 150
Columbia, MD 21045-2476

Mailing address

350 New Fidelity CT
Garner, NC 27529-2665
Phone (252) 248-3313

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240111001795 DC Practitioner - Physical Therapist in Private Practice 4789035098 Reassigns benefits to 1 organization
I20240112003935 MD Practitioner - Physical Therapist in Private Practice 4789035098 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Glen Burnie Physical Therapy and Sportscare LLCGroup PAC ID 0042102592, 25 clinicians
Maryland Sportscare and Rehab LLCGroup PAC ID 2860440427, 166 clinicians

Practice addresses (Care Compare)

5500 Knoll N Dr
Suite 150
Columbia, MD 21045-2476
Phone (443) 542-0062

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
29715MDMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Glen Burnie Physical Therapy & Sportscare, LLC Physical Therapist CurrentSince Jan 2, 2024 Accepting new patients
Glen Burnie Physical Therapy & Sportscare, LLC Physical Therapist CurrentSince Jan 2, 2024 Accepting new patients

Locations

2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250

5500 Knoll North Dr
Ste 150
Columbia, MD 21045
Phone (443) 542-0062

14700 Baltimore Ave
Unit 106
Laurel, MD 20707
Phone (240) 754-2203

3708 Mountain Rd
Ste D
Pasadena, MD 21122
Phone (410) 255-4833

350 New Fidelity Ct
Garner, NC 27529
Phone (919) 373-2919

Organizations & group practices 3

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": "1703116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704240000000",
    "number": "1871362681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 NEW FIDELITY CT",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275292665",
            "telephone_number": "252-248-3313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 KNOLL NORTH DR STE 150",
            "city": "COLUMBIA",
            "state": "MD",
            "postal_code": "210452476",
            "telephone_number": "443-542-0062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "CHARITY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-12-21",
        "last_updated": "2024-01-03",
        "certification_date": "2024-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "29715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.