Active NPI
Marcus Maier
- Physical Therapy Assistant
- Stoughton, WI
National Provider Identifier
1225181720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 977-019
- Practice address
- 400 N. Morris St.
Stoughton, WI 53589-1857 - Phone
- (608) 873-9454
- Fax
- (608) 873-5748
- NPI assigned
- Jan 19, 2007
- Sex
- Male
- 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 Therapy Assistant | 225200000X | 977-019 | WI | Primary |
Addresses
Primary practice location
400 N. Morris St.
Stoughton, WI 53589-1857
Mailing address
1405 E. Rd. 7
Edgerton, WI 53534-9027
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 40368700 | Medicaid | WI |
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 |
|---|---|---|---|
| 977-019 | WI | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169164800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1225181720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1405 E. RD. 7",
"city": "EDGERTON",
"state": "WI",
"postal_code": "535349027"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 N. MORRIS ST.",
"city": "STOUGHTON",
"state": "WI",
"postal_code": "535891857",
"telephone_number": "608-873-9454",
"fax_number": "608-873-5748"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAIER",
"first_name": "MARCUS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "WI",
"license": "977-019",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "40368700",
"state": "WI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Stoughton, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.