Active NPI
Marian E. Kirk, P.T.
- Physical Therapist
- Waldorf, MD
National Provider Identifier
1205124609
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 15480
- Practice address
- 2960 Technology Place
Suite 110
Waldorf, MD 20601 - Phone
- (301) 893-2366
- Fax
- (301) 893-0609
- NPI assigned
- Jul 19, 2011
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 15480 | MD | Primary |
Addresses
Primary practice location
2960 Technology Place
Suite 110
Waldorf, MD 20601
Mailing address
51 Monroe Street
Suite 1207
Rockville, MD 20850
Phone (301) 838-2040
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 |
|---|---|---|---|
| 15480 | MD | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rehab at Work, Corp. | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311033600000",
"number": "1205124609",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "51 MONROE STREET",
"address_2": "SUITE 1207",
"city": "ROCKVILLE",
"state": "MD",
"postal_code": "20850",
"telephone_number": "301-838-2040",
"fax_number": "301-838-2041"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2960 TECHNOLOGY PLACE",
"address_2": "SUITE 110",
"city": "WALDORF",
"state": "MD",
"postal_code": "20601",
"telephone_number": "301-893-2366",
"fax_number": "301-893-0609"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIRK",
"first_name": "MARIAN",
"middle_name": "E.",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-07-19",
"last_updated": "2011-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "15480",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waldorf, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.