Marlin Wayne Harris, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

14726 Issued in CA

Practice address

55500 South Circle Drive
Idyllwild, CA 92549

Phone

(951) 659-5163

Fax

(951) 659-5691

NPI assigned

Mar 28, 2018

Last updated

Mar 28, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Whitman Physical Therapy, Inc

  • Physical Therapist
  • Idyllwild, CA
  • NPI 1568580249
  NPD (past)

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

{
    "created_epoch": "1522195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522195200000",
    "number": "1023513306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3371",
            "city": "IDYLLWILD",
            "state": "CA",
            "postal_code": "925493371",
            "telephone_number": "951-852-4703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55500 SOUTH CIRCLE DRIVE",
            "city": "IDYLLWILD",
            "state": "CA",
            "postal_code": "92549",
            "telephone_number": "951-659-5163",
            "fax_number": "951-659-5691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "MARLIN",
        "middle_name": "WAYNE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-28",
        "last_updated": "2018-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "14726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• DRS Dunn & Dunn
• DRS Dunn & Dunn
• Susan Anne Freed, MOT, OTR/L, CHT
• Gail Harriss
• Cynthia Harlowe, RN
• Idyllwild Community Acupuncture & Bodywork, Inc. (Moving Lively)
• Idyllwild Fire Protection District
• Idyllwild Health Center
• Kelly Lovejoy, Licensed Clinical Social Worker, P.C. (Kelly Lovejoy LCW, PC)
• Kris' Camp/ Therapy Intensive Programs, Inc (Therapy Intensive Programs, Inc)

• Physical Therapist in Idyllwild, CA
• Providers in Idyllwild, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2018; 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.