Active NPI
Jean Marie Marx
- Student in an Organized Health Care Education/Training Program
- Saint James, NY
National Provider Identifier
1194029439
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- 22 Three Sisters Rd
Saint James, NY 11780-1223 - Phone
- (631) 697-3480
- NPI assigned
- Dec 30, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 021740-1 | NY | |
| Student in an Organized Health Care Education/Training Program | 390200000X | NY | Primary |
Addresses
Primary practice location
22 Three Sisters Rd
Saint James, NY 11780-1223
Mailing address
22 Three Sisters Rd
Saint James, NY 11780-1223
Phone (631) 697-3480
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 390200000X | Other | NY | CFY |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 021740-1 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1293667200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1332806400000",
"number": "1194029439",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 THREE SISTERS RD",
"city": "SAINT JAMES",
"state": "NY",
"postal_code": "117801223",
"telephone_number": "631-697-3480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22 THREE SISTERS RD",
"city": "SAINT JAMES",
"state": "NY",
"postal_code": "117801223",
"telephone_number": "631-697-3480"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARX",
"first_name": "JEAN",
"middle_name": "MARIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-12-30",
"last_updated": "2012-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "NY",
"license": "021740-1",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NY",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CFY",
"identifier": "390200000X",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Saint James, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.