Marissa Vardavas, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

8561 Market St
Boardman, OH 44512-6727

Phone

(330) 953-2383

Fax

(330) 953-2384

NPI assigned

Oct 2, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Kids Choice LLC

  • Speech-Language Pathologist
  • Boardman, OH
  • NPI 1568798544
  Medicare reassignment NPD
• Lock and Key ABA Therapy Group

  • Behavior Analyst
  • Boardman, OH
  • NPI 1558216168
  NPD (past)

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

{
    "created_epoch": "1727827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1144048604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8561 MARKET ST",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445126727",
            "telephone_number": "330-953-2383",
            "fax_number": "330-953-2384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8561 MARKET ST",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445126727",
            "telephone_number": "330-953-2383",
            "fax_number": "330-953-2384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARDAVAS",
        "first_name": "MARISSA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-10-02",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tricia Marie Vallinger, RBT
• Helen L Van Tassel, MED, LPCC
• Kathrine A Vance-Righetti, M ED, LPCC
• Robert Peter Vandekappelle Jr., M.D.
• Tracey Vantassel, MSED, LPCC, LSW
• Jennifer Varley
• Cynthia Esther Vega-Herrera, LPN
• Joelle Marie Venman, DPT
• Nicholas Ventigan
• Jennifer Viano

• Physical Therapist in Boardman, OH
• Providers in Boardman, OH by specialty
• Physical Therapist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.