Individual provider Active NPI

Mark Noble, DPT

  • Physical Therapist
  • San Diego, CA
National Provider Identifier
1164859401
Registry record updated Oct 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
40257 Issued in CA
Practice address
404 Camino del Rio S
Suite 508
San Diego, CA 92108-3503
Phone
(619) 325-0154
NPI assigned
Oct 1, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2013

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 40257 CA Primary
Physical Therapist 225100000X 2305208018 VA
Physical Therapist 225100000X P14301 NC
Physical Therapist 225100000X 7046 SC

Addresses

Primary practice location

404 Camino del Rio S
Suite 508
San Diego, CA 92108-3503

Mailing address

404 Camino del Rio S
Suite 508
San Diego, CA 92108-3503
Phone (619) 325-0154

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
P14301NCMDPhysical Therapist
7046SCMDPhysical Therapist
2305208018VAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1380585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380585600000",
    "number": "1164859401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "404 CAMINO DEL RIO S",
            "address_2": "SUITE 508",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083503",
            "telephone_number": "619-325-0154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "404 CAMINO DEL RIO S",
            "address_2": "SUITE 508",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921083503",
            "telephone_number": "619-325-0154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOBLE",
        "first_name": "MARK",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-01",
        "last_updated": "2013-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "40257",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305208018",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P14301",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "7046",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2013; 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.