Individual provider Active NPI

Marion Louise Jolivette

  • Physical Therapy Assistant
  • San Antonio, TX
National Provider Identifier
1043792443
Registry record updated Aug 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2-0225-9 Issued in TX
Practice address
307 W Cypress St
San Antonio, TX 78212-5512
Phone
(210) 223-5521
NPI assigned
Aug 31, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 225200000X 2-0225-9 TX Primary
Physical Medicine & Rehabilitation Physician 208100000X 2-0225-9 TX

Addresses

Primary practice location

307 W Cypress St
San Antonio, TX 78212-5512

Mailing address

PO Box 33284
San Antonio, TX 78265-3284
Phone (210) 452-9649

Other practice location 1

307 W Cypress St
San Antonio, TX 78212-5512
Phone (210) 223-5521 ext. 2635

Other practice location 2

307 W Cypress St
San Antonio, TX 78212-5512
Phone (210) 223-5521 ext. 2635

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2-0225-9TXMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1535673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535673600000",
    "number": "1043792443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 33284",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782653284",
            "telephone_number": "210-452-9649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 W CYPRESS ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782125512",
            "telephone_number": "210-223-5521"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "307 W Cypress St",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782125512",
            "country_code": "US",
            "telephone_number": "210-223-5521 x2635",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "307 W Cypress St",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782125512",
            "country_code": "US",
            "telephone_number": "210-223-5521 x2635",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOLIVETTE",
        "first_name": "MARION",
        "middle_name": "LOUISE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-31",
        "last_updated": "2018-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2-0225-9",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TX",
            "license": "2-0225-9",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 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.