Individual provider Active NPI

Marcia Everson, PT

  • Physical Therapist
  • Wasilla, AK
National Provider Identifier
1023478989
Registry record updated Mar 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1166 Issued in AK
Practice address
650 N Shoreline Dr
Wasilla, AK 99654-6677
Phone
(907) 376-6363
Fax
(907) 376-6366
NPI assigned
Mar 3, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2016

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 1166 AK Primary

Addresses

Primary practice location

650 N Shoreline Dr
Wasilla, AK 99654-6677

Mailing address

650 N Shoreline Dr
Wasilla, AK 99654-6677

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

NPI Registry JSON

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

{
    "created_epoch": "1456963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456963200000",
    "number": "1023478989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "650 N SHORELINE DR",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996546677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 N SHORELINE DR",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "996546677",
            "telephone_number": "907-376-6363",
            "fax_number": "907-376-6366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVERSON",
        "first_name": "MARCIA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-03-03",
        "last_updated": "2016-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AK",
            "license": "1166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasilla, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2016; 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.