Active NPI
Marisa Leigh King, PAC
- Physician Assistant
- Virginia Beach, VA
National Provider Identifier
1164636304
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 0110006161
- Practice address
- 3432 Holland Rd
Virginia Beach, VA 23452-4846 - Phone
- (757) 468-1855
- NPI assigned
- May 9, 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0110006161 | VA | Primary |
Addresses
Primary practice location
3432 Holland Rd
Virginia Beach, VA 23452-4846
Mailing address
5000 Cox Rd
Glen Allen, VA 23060-9263
Phone (804) 968-5700
Other names 1
- Marisa Leigh Strother
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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1205 | WV | MD | Psychologist |
| 0110006161 | VA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1566259200000",
"number": "1164636304",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5000 COX RD",
"city": "GLEN ALLEN",
"state": "VA",
"postal_code": "230609263",
"telephone_number": "804-968-5700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3432 HOLLAND RD",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "234524846",
"telephone_number": "757-468-1855"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KING",
"first_name": "MARISA",
"middle_name": "LEIGH",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-09",
"last_updated": "2019-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "VA",
"license": "0110006161",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "MARISA",
"last_name": "STROTHER",
"middle_name": "LEIGH",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.