Marijke Schupack, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2174 Issued in AZ

Practice address

191 Lynx Dr
Sedona, AZ 86336-7142

Phone

(928) 203-4337

NPI assigned

Sep 2, 2006

Sex

Female

Sole proprietor

Yes

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.

• Northern Arizona Physical Therapy Services PLLC

  • Physical Therapy Clinic/Center
  • Sedona, AZ
  • NPI 1881993996
  NPD (past) Authorized official

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 10, 2009.

{
    "created_epoch": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247184000000",
    "number": "1164524914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 LYNX DR",
            "city": "SEDONA",
            "state": "AZ",
            "postal_code": "863367142",
            "telephone_number": "928-203-4337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 LYNX DR",
            "city": "SEDONA",
            "state": "AZ",
            "postal_code": "863367142",
            "telephone_number": "928-203-4337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHUPACK",
        "first_name": "MARIJKE",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-02",
        "last_updated": "2009-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "2174",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Philip A Sauer, P.T
• Carol Schafer, PT
• Deborah C Schindele, NP
• Richard Schonberg, PSY.D.
• Janett J Schor, M.D.
• Stuart Allan Seale, M.D.
• Troy D Sebastian, RPSGT
• Sedona Center for Complementary Medicine, Inc
• Sedona Core Counseling
• Sedona Dental Arts, LLC

• All providers in Sedona, AZ
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.