Active NPI
Marjorie Susan Mitchell, PTA
- Physical Therapy Assistant
- Waxahachie, TX
National Provider Identifier
1114408424
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2066760
- Practice address
- 151 Country Meadows Blvd
Waxahachie, TX 75165-7811 - Phone
- (972) 937-1650
- NPI assigned
- Aug 24, 2018
- Last updated
- Aug 24, 2018
- 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 |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2066760 | TX | Primary |
Addresses
Primary practice location
151 Country Meadows Blvd
Waxahachie, TX 75165-7811
Mailing address
PO Box 688
Grandview, TX 76050-0688
Phone (817) 988-1273
Other practice location 1
724 W Rendon Crowley Rd
Fort Worth, TX 76036
Phone (817) 297-4141
Other practice location 2
4201 Stonegate Blvd
Fort Worth, TX 76109-9503
Phone (817) 924-5440
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
| License | State | Type | Specialty |
|---|---|---|---|
| 2066760 | TX | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1535068800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1535068800000",
"number": "1114408424",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 688",
"city": "GRANDVIEW",
"state": "TX",
"postal_code": "760500688",
"telephone_number": "817-988-1273",
"fax_number": "817-866-2979"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "151 COUNTRY MEADOWS BLVD",
"city": "WAXAHACHIE",
"state": "TX",
"postal_code": "751657811",
"telephone_number": "972-937-1650"
}
],
"practiceLocations": [
{
"address_1": "724 W Rendon Crowley Rd",
"address_purpose": "LOCATION",
"city": "Fort Worth",
"state": "TX",
"postal_code": "76036",
"country_code": "US",
"telephone_number": "817-297-4141",
"fax_number": "888-253-1575",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "4201 Stonegate Blvd",
"address_purpose": "LOCATION",
"city": "Fort Worth",
"state": "TX",
"postal_code": "761099503",
"country_code": "US",
"telephone_number": "817-924-5440",
"fax_number": "817-924-5447",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MITCHELL",
"first_name": "MARJORIE",
"middle_name": "SUSAN",
"name_prefix": "Mrs.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-08-24",
"last_updated": "2018-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TX",
"license": "2066760",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waxahachie, TX
- Mind Above Matter LLC
- Mavis Mingle, PHARM. D
- Shelley Minor
- Mint Dentistry, PLLC (Waxahachie MINT Dentistry)
- Mission Possible ABA, LLC
- Achal Pankaj Modi, MD
- Montica a. O'Barr (Ready To Change Counseling)
- April Watkins Moody, LPC
- Moore & Bodine Orthodontics, PLLC (Moor & Bodine Orthodontics)
- Dekeisha Moore-Barrett, LCSW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 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.