Active NPI
Elizabeth R. Marks, DPT
- Specialist
- Natchez, MS
National Provider Identifier
1104177823
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- PT4507
- Practice address
- 55 SGT Prentiss Dr
Suite 8
Natchez, MS 39120-4782 - Phone
- (601) 446-8764
- Fax
- (601) 446-8745
- NPI assigned
- Sep 20, 2012
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | PT4507 | MS | Primary |
Addresses
Primary practice location
55 SGT Prentiss Dr
Suite 8
Natchez, MS 39120-4782
Mailing address
55 SGT Prentiss Dr
Suite 8
Natchez, MS 39120-4782
Phone (601) 446-8764
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 |
|---|---|---|---|
| PT4507 | MS | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348099200000",
"number": "1104177823",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 SGT PRENTISS DR",
"address_2": "SUITE 8",
"city": "NATCHEZ",
"state": "MS",
"postal_code": "391204782",
"telephone_number": "601-446-8764",
"fax_number": "601-446-8745"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 SGT PRENTISS DR",
"address_2": "SUITE 8",
"city": "NATCHEZ",
"state": "MS",
"postal_code": "391204782",
"telephone_number": "601-446-8764",
"fax_number": "601-446-8745"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARKS",
"first_name": "ELIZABETH",
"middle_name": "R.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-09-20",
"last_updated": "2012-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "MS",
"license": "PT4507",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Natchez, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.