CHARLES GLENN BLACK (NPI# 1053424234) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053424234 |
| Entity Type | Individual |
| Full Name | CHARLES GLENN BLACK |
| Credential | PT |
| Practice Address |
1231 Colonial Park Dr Severn MD 21144-4417 |
| Practice Telephone | 4105701446 |
| Mailing Telephone | 4105701446 |
| Mailing Fax Number | 4107217580 |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2009-05-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225100000X | Physical Therapist | 18275 | MD | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| BCBS OF MARYLAND | 18GMMA | 01 | |
| GHMSI/BLUECHOICE | 5120 | 01 | |
| ACN | 701076 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205094240 | Charles Randall Black | Dentist | 26 Long Pond Road, Plymouth County Correctional Facility, Plymouth, MA 02360-2606 | 2008-05-27 |
| 1962555342 | Charles Leonard Black | Emergency Medicine | 7600 General Motors Blvd, Medical Department, Shreveport, LA 71129-9426 | 2007-01-19 |
| 1356407902 | Charles Brad Black | Family Medicine | 214 E 3rd St, Libby, MT 59923-2056 | 2006-12-28 |
| 1528049723 | Charles Thomas Black | Surgery | 12200 Park Central Dr Ste 400, Dallas, TX 75251-2116 | 2005-11-07 |
| 1972754950 | Charles Black IIi | Dentist | 4728 Airport Blvd, Suite C, Mobile, AL 36608 | 2008-10-08 |
| 1790988087 | Charles Henry Black Iv | Orthopaedic Surgery | 1002 Jefferson St., Suite 350, Laurel, MS 39440-4306 | 2007-06-06 |
| 1427196096 | Charles Alexander Black Jr. | Technician, Other | 427 Commercial St, Boston, MA 02109-1027 | 2007-02-03 |
| 1497764187 | Charles B Black | Surgery | 1010 Three Springs Blvd, Durango, CO 81301-8296 | 2006-08-05 |
| 1730111378 | Charles Joseph Black | Social Worker | 4355 Ferguson Dr, Suite 270, Cincinnati, OH 45245-5136 | 2006-07-06 |
| 1992744981 | Charles Black | Surgery | 1534 Elizabeth Ave, Suite 202, Shreveport, LA 71101-4516 | 2006-06-05 |
| Street Address |
1231 COLONIAL PARK DR |
| City | SEVERN |
| State | MD |
| Zip Code | 21144-4417 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033724786 | Life Force for Older Americans, Inc. | In Home Supportive Care | 1869 Hawk Court, Severn, MD 21144 | 2020-09-10 |
| 1154942043 | Alysia Frances Henderson | Specialist/Technologist | 7675 Baltimore Avenue, Ritchie Coliseum 0100, College Park, MD 21144 | 2020-05-01 |
| 1952952251 | Cristelyne Galutira | Behavior Technician | 8303 Canyon Oak Dr, Severn, MD 21144 | 2019-09-27 |
| 1710542717 | Seleste Upshaw | Nurse Practitioner | 524 Hidden Valley Court, Severn, MD 21144 | 2019-05-06 |
| 1528538105 | Life Support Clinical Counseling Service LLC | Counselor | 82 Janet Dale Ln, Severn, MD 21144 | 2018-11-27 |
| 1972088045 | Abundant Life and Wellness Counseling Services, LLC | Counselor | 1812 Encore Ter, Severn, MD 21144 | 2018-09-25 |
| 1528544731 | Allegiance Chiropractic LLC | Chiropractor | 2622h Annapolis Rd, Severn, MD 21144 | 2018-07-11 |
| 1922554526 | Amana Khondaker | Pharmacist | 2600 Annapolis Rd., Severn, MD 21144 | 2016-09-01 |
| 1457707960 | Caroline Akomolede | Licensed Practical Nurse | 8420 Gale Lane, Aa, Severn, MD 21144 | 2016-05-13 |
| 1306184726 | Casey Mary Mccall | Counselor | 1157 Reece Road, Severn, MD 21144 | 2013-01-18 |
| Find all providers in zip 21144 | ||||
| Taxonomy Code | 225100000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT’s assess joint motion, muscle strength and endurance, function of heart and lungs, and performance of activities required in daily living, among other responsibilities. Treatment includes therapeutic exercises, cardiovascular endurance training, and training in activities of daily living. (2) A physical therapist is a person qualified by an accredited program in physical therapy, licensed by the state, and practicing within the scope of that license. Physical therapists treat disease, injury, or loss of a bodily part by physical means, such as the application of light, heat, cold, water, electricity, massage and exercise. They develop treatment plans based upon each patient’s strengths, weaknesses, range of motion and ability to function. (3) A health professional who specializes in physical therapy- the health care field concerned primarily with the treatment of disorders with physical agents and methods, such as massage, manipulation, therapeutic exercises, cold, heat (including short-wave, microwave, and ultrasonic diathermy), hydrotherapy, electric stimulation and light to assist in rehabilitating patients and in restoring normal function after an illness or injury. |
| Notes: Source: (1) APTA Guidelines for Physical Therapy Claims Review, American Physical Therapy Association. (3) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558538488 | Philip Francis Malaya Relativo | Physical Therapist | 1433 Illinois Ave, Severn, MD 21144-2641 | 2008-05-09 |
| 1750569109 | Lorden Roderick Warrington | Physical Therapist | 8421 Terry Lee Way, Severn, MD 21144-3467 | 2008-02-07 |
| 1720269335 | Mariesol Figueroa Wallace | Physical Therapist | 1615 Horsedrawn Ct, Severn, MD 21144-6808 | 2007-11-26 |
| 1205981883 | Antara Desai | Physical Therapist | 8505 Pine Springs Dr, Severn, MD 21144-6818 | 2007-01-24 |
| 1578163739 | Desai Physical Therapy Inc | Physical Therapist | 8505 Pine Springs Dr, Severn, MD 21144-6818 | 2020-10-27 |
| 1427495837 | Maria Celeste Cundangan | Physical Therapist | 1433 Illinois Ave, Severn, MD 21144-2641 | 2013-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750981551 | Ralp Lagat Betonio | Physical Therapist | 3901 Chelsea Park Ln Apt 12, Burtonsville, MD 20866-2112 | 2020-10-29 |
| 1336747930 | Melissa Wohlberg | Physical Therapist | 1700 Reisterstown Rd Ste 109, Pikesville, MD 21208-2978 | 2020-10-15 |
| 1912505025 | Michelle Mikesell | Physical Therapist | 8699 S Pacific Ct, Middletown, MD 21769-8535 | 2020-10-12 |
| 1629675087 | Kari Hough | Physical Therapist | 5130 Dorsey Hall Dr Fl 1, Ellicott City, MD 21042-7870 | 2020-10-07 |
| 1235736984 | Dawn Maria Seestedt | Physical Therapist | 2501 Poplar Dr, Baltimore, MD 21207-6032 | 2020-10-06 |
| 1669079455 | Rebecca Cynthia White | Physical Therapist | 1700 Reisterstown Rd Ste 125, Pikesville, MD 21208-2978 | 2020-10-05 |
| 1023615929 | Nicholas Alan Ritter | Physical Therapist | 2709 Hampden Ave, Baltimore, MD 21211-3031 | 2020-10-04 |
| 1790392058 | Tyler James Thornburg | Physical Therapist | 1207 Liberty Rd # 106, Eldersburg, MD 21784-6574 | 2020-09-30 |
| 1225645195 | Annapolis Family Physical Therapy, Inc | Physical Therapist | 979 Bay Village Dr, Annapolis, MD 21403-4089 | 2020-09-25 |
| 1811504608 | Strive Sports Medicine Physical Therapy, LLC | Physical Therapist | 206 N Fruitland Blvd, Fruitland, MD 21826-1717 | 2020-09-25 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.