Individual provider Active NPI

Brett A Wiegrefe, PT

  • Physical Therapist
  • Baltimore, MD
National Provider Identifier
1972697977
Registry record updated May 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
21016 Issued in MD
Practice address
9110 Philadelphia Rd Ste 314
Baltimore, MD 21237-4327
Phone
(410) 616-1401
Fax
(410) 686-6315
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2019

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 21016 MD Primary

Addresses

Primary practice location

9110 Philadelphia Rd Ste 314
Baltimore, MD 21237-4327

Mailing address

8322 Bellona Ave
Suite 100
Towson, MD 21204-2012
Phone (410) 337-8847

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD, DC2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040908000531 MD Practitioner - Physical Therapist in Private Practice 1153397401 Reassigns benefits to 4 organizations
I20180607000341 DC Practitioner - Physical Therapist in Private Practice 1153397401 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
21016MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Medical Regional Professional Services, LLC Physical Therapist CurrentSince Feb 1, 2013 Accepting new patients
LHMG Physical Therapy, LLC Physical Therapist CurrentSince Mar 19, 2018 Accepting new patients
Annapolis Family Physical Therapy, Inc Physical Therapist CurrentSince Sep 26, 2023 Accepting new patients
University of Maryland Medical Regional Professional Services, LLC Physical Therapist CurrentSince Feb 1, 2013 Accepting new patients
LHMG Physical Therapy, LLC Physical Therapist Current Accepting new patients
Annapolis Family Physical Therapy, Inc Physical Therapist CurrentSince Sep 26, 2023 Accepting new patients
LHMG Physical Therapy, LLC Physical Therapist CurrentSince Mar 19, 2018 Accepting new patients
LHMG Physical Therapy, LLC Physical Therapist CurrentSince Mar 19, 2018 Accepting new patients
2 WS LLC CurrentSince Sep 26, 2023 Accepting new patients
Orthopaedic Associates, PA Past Accepting new patients
Orthopaedic Associates, PA Past Accepting new patients

Locations

2564 Riva Rd
Annapolis, MD 21401
Phone (410) 266-6626

2006 Industrial Dr
Annapolis, MD 21401
Phone (410) 266-7174

4175 N Hanson Ct
Ste 301
Bowie, MD 20716
Phone (301) 805-0190

6836 Race Track Rd
Bowie, MD 20715
Phone (301) 805-7004

1153 State Route 3 N
Ste 35
Gambrills, MD 21054
Phone (410) 216-2200

8638 Veterans Hwy
Fl 1
Millersville, MD 21108
Phone (410) 729-4508

8109 Ritchie Hwy
Ste 600
Pasadena, MD 21122
Phone (410) 553-3515

9110 Philadelphia Rd
Ste 314
Rosedale, MD 21237
Phone (410) 616-1401

156 Ritchie Hwy
Ste 100
Severna Park, MD 21146
Phone (410) 279-0654

8322 Bellona Ave
Rm 100
Towson, MD 21204
Phone (410) 337-7900

Organizations & group practices 11

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1558310400000",
    "number": "1972697977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8322 BELLONA AVE",
            "address_2": "SUITE 100",
            "city": "TOWSON",
            "state": "MD",
            "postal_code": "212042012",
            "telephone_number": "410-337-8847",
            "fax_number": "410-769-8591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9110 PHILADELPHIA RD STE 314",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212374327",
            "telephone_number": "410-616-1401",
            "fax_number": "410-686-6315"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WIEGREFE",
        "first_name": "BRETT",
        "middle_name": "A",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2019-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "21016",
            "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 May 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.