Active NPI
Nielsen Atchinson, PT
- Physical Therapist
- Waldorf, MD
National Provider Identifier
1912017609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 12070 Old Line Ctr
Suite 107
Waldorf, MD 20602-2513 - Phone
- (301) 374-6885
- Fax
- (301) 374-6893
- NPI assigned
- Aug 30, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
12070 Old Line Ctr
Suite 107
Waldorf, MD 20602-2513
Mailing address
4714 Gettysburg Rd
Suite 400
Mechanicsburg, PA 17055-4325
Phone (717) 972-1100
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 21409 | Other | MD | LICENSE # |
| 015514 | Other | NY | PT LICENSE |
| PT870601 | Other | DC | PT LICENSE |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Active Physical Therapy Services, LLC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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
- Laurel, MD
- NPI 1225217334
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1441843200000",
"number": "1912017609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4714 GETTYSBURG RD",
"address_2": "SUITE 400",
"city": "MECHANICSBURG",
"state": "PA",
"postal_code": "170554325",
"telephone_number": "717-972-1100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12070 OLD LINE CTR",
"address_2": "SUITE 107",
"city": "WALDORF",
"state": "MD",
"postal_code": "206022513",
"telephone_number": "301-374-6885",
"fax_number": "301-374-6893"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ATCHINSON",
"first_name": "NIELSEN",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2015-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE #",
"identifier": "21409",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PT LICENSE",
"identifier": "015514",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PT LICENSE",
"identifier": "PT870601",
"state": "DC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Waldorf, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.