Active NPI
Susan D Marr, PTA
- Physical Therapy Assistant
- Gilbert, AZ
National Provider Identifier
1124205000
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 0015A
- Practice address
- 2935 S. Recker Rd.
Gilbert, AZ 85295 - Phone
- (480) 279-5000
- NPI assigned
- Jan 23, 2008
- 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 | 0015A | Primary |
Addresses
Primary practice location
2935 S. Recker Rd.
Gilbert, AZ 85295
Mailing address
2671 E Park Ave
Gilbert, AZ 85234-6310
Phone (480) 632-1259
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crystal Oaks Long Term Care | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Skilled Nursing Facility
- Festus, MO
- NPI 1467592618
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1201046400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1201046400000",
"number": "1124205000",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2671 E PARK AVE",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852346310",
"telephone_number": "480-632-1259"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2935 S. RECKER RD.",
"city": "GILBERT",
"state": "AZ",
"postal_code": "85295",
"telephone_number": "480-279-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARR",
"first_name": "SUSAN",
"middle_name": "D",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-01-23",
"last_updated": "2008-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": null,
"license": "0015A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gilbert, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.