Active NPI
Marin S Easter
- Physical Therapist
- Fort Polk, LA
National Provider Identifier
1124236575
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PTH4422
- Practice address
- 1585 3Rd St
Fort Polk, LA 71459-5102 - Phone
- (337) 531-3118
- NPI assigned
- May 18, 2007
- 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 Therapist | 225100000X | PTH4422 | AL | Primary |
Addresses
Primary practice location
1585 3Rd St
Fort Polk, LA 71459-5102
Mailing address
245 Charles Duttry Rd
Deridder, LA 70634-7411
Phone (256) 366-6731
Other practice location 1
2030 14th St Bldg 1830
Fort Polk, LA 71459-5302
Phone (337) 531-4021
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 |
|---|---|---|---|
| PTH4422 | AL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635811200000",
"number": "1124236575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "245 CHARLES DUTTRY RD",
"city": "DERIDDER",
"state": "LA",
"postal_code": "706347411",
"telephone_number": "256-366-6731"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1585 3RD ST",
"city": "FORT POLK",
"state": "LA",
"postal_code": "714595102",
"telephone_number": "337-531-3118"
}
],
"practiceLocations": [
{
"address_1": "2030 14th St Bldg 1830",
"address_purpose": "LOCATION",
"city": "Fort Polk",
"state": "LA",
"postal_code": "714595302",
"country_code": "US",
"telephone_number": "337-531-4021",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "EASTER",
"first_name": "MARIN",
"middle_name": "S",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-18",
"last_updated": "2021-11-02",
"certification_date": "2021-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AL",
"license": "PTH4422",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fort Polk, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.