Active NPI
Kristine Marie Gavrilis, PT
- Physical Therapist
- Baltimore, MD
National Provider Identifier
1962619973
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 22139
- Practice address
- 2001 N Warwick Ave
Baltimore, MD 21216-3203 - Phone
- (410) 396-0833
- NPI assigned
- May 17, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 22139 | MD | Primary |
Addresses
Primary practice location
2001 N Warwick Ave
Baltimore, MD 21216-3203
Mailing address
4620 Silver Spring Rd
Perry Hall, MD 21128-9008
Phone (973) 222-2711
Other practice location 1
101 Walter Ward Boulevard
Abingdon, MD 21009-1210
Phone (443) 643-1828
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22139 | MD | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Upper Chesapeake Health Rehabilitation 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.
-
- Rehabilitation Hospital Unit
- Aberdeen, MD
- NPI 1578697629
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551916800000",
"number": "1962619973",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4620 SILVER SPRING RD",
"city": "PERRY HALL",
"state": "MD",
"postal_code": "211289008",
"telephone_number": "973-222-2711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2001 N WARWICK AVE",
"city": "BALTIMORE",
"state": "MD",
"postal_code": "212163203",
"telephone_number": "410-396-0833"
}
],
"practiceLocations": [
{
"address_1": "101 Walter Ward Boulevard",
"address_purpose": "LOCATION",
"city": "Abingdon",
"state": "MD",
"postal_code": "210091210",
"country_code": "US",
"telephone_number": "443-643-1828",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GAVRILIS",
"first_name": "KRISTINE",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-17",
"last_updated": "2019-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "22139",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Baltimore, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.