Marlene Kosobucki, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1979 Issued in WI

Practice address

1200 Grant Blvd W
Wabasha, MN 55981-1042

Phone

(651) 565-4531

NPI assigned

Sep 25, 2006

Last updated

Nov 20, 2008By the provider in NPPES

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

Other identifiers 1

Other names 1

• Marlene Kosobucki Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227139200000",
    "number": "1174623334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 GRANT BLVD W",
            "city": "WABASHA",
            "state": "MN",
            "postal_code": "559811042",
            "telephone_number": "651-565-4531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 GRANT BLVD W",
            "city": "WABASHA",
            "state": "MN",
            "postal_code": "559811042",
            "telephone_number": "651-565-4531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOSOBUCKI",
        "first_name": "MARLENE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2008-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "1979",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "40104500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARLENE",
            "last_name": "KOSOBUCKI",
            "credential": "P.T.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Physical Therapist in Wabasha, MN
• Providers in Wabasha, MN by specialty
• Physical Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2008; 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.