Trevon Tamar McDaniel

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

A5391 Issued in MD

Practice address

165 Thomas Johnson Dr
Frederick, MD 21702-4742

Phone

(301) 694-8311

NPI assigned

Sep 18, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1600387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600387200000",
    "number": "1881200541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "398 FORD CIR",
            "city": "INWOOD",
            "state": "WV",
            "postal_code": "254284406",
            "telephone_number": "304-820-9413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 THOMAS JOHNSON DR",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024742",
            "telephone_number": "301-694-8311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDANIEL",
        "first_name": "TREVON",
        "middle_name": "TAMAR",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-18",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "WV",
            "license": "002673",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "MD",
            "license": "A5391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian McCrohan, LGPC
• Lisa McCrohan, LCSW-C
• Kelsey McCulley, ATC
• Wesley Thomas McCulley, LCSW-C
• Stefanie Jean McDaniel, RPH
• Diana Erin McDermott, PHARM. D
• Jacob Aaron McDonald, LCPC
• Jennifer Nicole McDonald, D.O.
• Kristen McDonald, DC
• Pamela Marsh McDonald, LCSW-C

• Physical Therapy Assistant in Frederick, MD
• Providers in Frederick, MD by specialty
• Physical Therapy Assistant in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.