Individual provider Active NPI

Mary Elizabeth Duvall, D.P.T.

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1013159805
Registry record updated Mar 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
33181 Issued in CA
Practice address
4747 Mission Blvd
Suite 4
San Diego, CA 92109-2541
Phone
(858) 581-6900
Fax
(858) 581-6999
NPI assigned
Mar 25, 2009
Last updated
Mar 25, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2009

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 33181 CA Primary

Addresses

Primary practice location

4747 Mission Blvd
Suite 4
San Diego, CA 92109-2541

Mailing address

4747 Mission Blvd
Suite 4
San Diego, CA 92109-2541
Phone (858) 581-6900

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

LicenseStateTypeSpecialty
33181CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Shefit Physical Therapy Physical Therapist Past Accepting new patients
PT First Physical Therapy PC Physical Therapist PastSince Jul 28, 2024 Accepting new patients
Foundation Therapy Center-Alpharetta, LLC Physical Therapist Past Accepting new patients
Reid Clinic Sports Physical Therapy and Spine LLC PastSince Aug 25, 2024 Accepting new patients
Tassinari Physical Therapy Inc Physical Therapist PastSince Mar 1, 2000 Accepting new patients
Foundation Therapy Center - North Atlanta, LLC Physical Therapist PastSince May 1, 2017 Accepting new patients

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1237939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237939200000",
    "number": "1013159805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4747 MISSION BLVD",
            "address_2": "SUITE 4",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921092541",
            "telephone_number": "858-581-6900",
            "fax_number": "858-581-6999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4747 MISSION BLVD",
            "address_2": "SUITE 4",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921092541",
            "telephone_number": "858-581-6900",
            "fax_number": "858-581-6999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUVALL",
        "first_name": "MARY",
        "middle_name": "ELIZABETH",
        "credential": "D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-25",
        "last_updated": "2009-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "33181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.