Active NPI
Stephen Condon, PTA
- Physical Therapy Assistant
- Bowie, MD
National Provider Identifier
1932685948
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PENDING
- Practice address
- 15500 Annapolis Rd
Bowie, MD 20715-3001 - Phone
- (443) 481-1140
- NPI assigned
- Jul 12, 2018
- Last updated
- Jul 12, 2018
- Sex
- Male
- 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 Therapy Assistant | 225200000X | PENDING | MD | Primary |
Addresses
Primary practice location
15500 Annapolis Rd
Bowie, MD 20715-3001
Mailing address
201 Defense Hwy Ste 100
Annapolis, MD 21401-8902
Phone (667) 204-7000
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PENDING | MD | MD | Critical Care Pediatric Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1531353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1531353600000",
"number": "1932685948",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "201 DEFENSE HWY STE 100",
"city": "ANNAPOLIS",
"state": "MD",
"postal_code": "214018902",
"telephone_number": "667-204-7000",
"fax_number": "443-481-6515"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15500 ANNAPOLIS RD",
"city": "BOWIE",
"state": "MD",
"postal_code": "207153001",
"telephone_number": "443-481-1140"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONDON",
"first_name": "STEPHEN",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-07-12",
"last_updated": "2018-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "MD",
"license": "PENDING",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bowie, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.