Active NPI
Melissa Charlotte Marviglia, DPT
- Pediatric Physical Therapist
- Gilbert, AZ
National Provider Identifier
1013134717
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- 5899
- Practice address
- 3341 E Queen Creek Rd
Suite 109
Gilbert, AZ 85297-8501 - Phone
- (480) 621-8361
- Fax
- (480) 621-8513
- NPI assigned
- Apr 20, 2007
- 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 |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | 5899 | AZ | Primary |
Addresses
Primary practice location
3341 E Queen Creek Rd
Suite 109
Gilbert, AZ 85297-8501
Mailing address
4771 E Meadow Lark Way
Queen Creek, AZ 85240-5207
Phone (480) 830-2445
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 722729 | Medicaid | AZ |
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 |
|---|---|---|---|
| 5899 | AZ | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177027200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186963200000",
"number": "1013134717",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4771 E MEADOW LARK WAY",
"city": "QUEEN CREEK",
"state": "AZ",
"postal_code": "852405207",
"telephone_number": "480-830-2445",
"fax_number": "480-677-8921"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3341 E QUEEN CREEK RD",
"address_2": "SUITE 109",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852978501",
"telephone_number": "480-621-8361",
"fax_number": "480-621-8513"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARVIGLIA",
"first_name": "MELISSA",
"middle_name": "CHARLOTTE",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-20",
"last_updated": "2007-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "AZ",
"license": "5899",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "722729",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Gilbert, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.