Active NPI
David A Marriott Jr., PT
- Physical Therapist
- Sykesville, MD
National Provider Identifier
1215058391
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 20769
- Practice address
- 450 Hawkridge LN
Sykesville, MD 21784-7652 - Phone
- (443) 603-6362
- NPI assigned
- Apr 3, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 | 20769 | MD | Primary |
Addresses
Primary practice location
450 Hawkridge LN
Sykesville, MD 21784-7652
Mailing address
450 Hawkridge LN
Sykesville, MD 21784-7652
Phone (443) 603-6362
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 61777101 | Other | MD-COMMERCIAL NUMBER |
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 |
|---|---|---|---|
| 20769 | MD | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175558400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1522281600000",
"number": "1215058391",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "450 HAWKRIDGE LN",
"city": "SYKESVILLE",
"state": "MD",
"postal_code": "217847652",
"telephone_number": "443-603-6362"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "450 HAWKRIDGE LN",
"city": "SYKESVILLE",
"state": "MD",
"postal_code": "217847652",
"telephone_number": "443-603-6362"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARRIOTT",
"first_name": "DAVID",
"middle_name": "A",
"name_suffix": "Jr.",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-03",
"last_updated": "2018-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "20769",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MD-COMMERCIAL NUMBER",
"identifier": "61777101",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Sykesville, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.