Active NPI
Marlys J Taylor, LISW
- Social Worker
- Carroll, IA
National Provider Identifier
1154300440
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 03151
- Practice address
- 311 S Clark St
Carroll, IA 51401-3038 - Phone
- (712) 792-3581
- Fax
- (712) 792-8475
- NPI assigned
- Jan 13, 2006
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 03151 | IA | Primary |
Addresses
Primary practice location
311 S Clark St
Carroll, IA 51401-3038
Mailing address
311 S Clark St
Carroll, IA 51401-3038
Phone (712) 792-3581
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0460790 | Medicaid | IA |
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 |
|---|---|---|---|
| 03151 | IA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1154300440",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "311 S CLARK ST",
"city": "CARROLL",
"state": "IA",
"postal_code": "514013038",
"telephone_number": "712-792-3581",
"fax_number": "712-792-8475"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "311 S CLARK ST",
"city": "CARROLL",
"state": "IA",
"postal_code": "514013038",
"telephone_number": "712-792-3581",
"fax_number": "712-792-8475"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAYLOR",
"first_name": "MARLYS",
"middle_name": "J",
"credential": "LISW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-01-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IA",
"license": "03151",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0460790",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Carroll, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.