Active NPI
Michele Sue Marino, PTA
- Specialist
- Tallmadge, OH
National Provider Identifier
1235360728
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- PTA
- Practice address
- 563 Colony Park Dr
Tallmadge, OH 44278-2859 - Phone
- (330) 634-0973
- NPI assigned
- Jul 31, 2009
- 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 |
|---|---|---|---|---|
| Specialist | 174400000X | PTA | OH | Primary |
Addresses
Primary practice location
563 Colony Park Dr
Tallmadge, OH 44278-2859
Mailing address
563 Colony Park Dr
Tallmadge, OH 44278-2859
Phone (330) 634-0973
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 |
|---|---|---|---|
| PTA | OH | MD | Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1248998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1248998400000",
"number": "1235360728",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "563 COLONY PARK DR",
"city": "TALLMADGE",
"state": "OH",
"postal_code": "442782859",
"telephone_number": "330-634-0973"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "563 COLONY PARK DR",
"city": "TALLMADGE",
"state": "OH",
"postal_code": "442782859",
"telephone_number": "330-634-0973"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARINO",
"first_name": "MICHELE",
"middle_name": "SUE",
"name_prefix": "Ms.",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-31",
"last_updated": "2009-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "OH",
"license": "PTA",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tallmadge, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.