Individual provider Active NPI

Marliese Spence Delgado, MS, PT

  • Pediatric Physical Therapist
  • Birmingham, AL
National Provider Identifier
1275636359
Registry record updated Apr 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
PTH2643 Issued in AL
Practice address
120 Oslo Cir
Birmingham, AL 35211-5965
Phone
(205) 944-3944
Fax
(205) 413-4914
NPI assigned
Sep 6, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTH2643 AL
Pediatric Physical Therapist 2251P0200X PTH2643 AL Primary

Addresses

Primary practice location

120 Oslo Cir
Birmingham, AL 35211-5965

Mailing address

100 Oslo Cir
Birmingham, AL 35211-5965
Phone (205) 944-3944

Other identifiers 2

IdentifierTypeStateIssuer
51037761OtherBCBS
890004070MedicaidAL

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
PTH2643ALMDPhysical Therapist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555632000000",
    "number": "1275636359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 OSLO CIR",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352115965",
            "telephone_number": "205-944-3944",
            "fax_number": "205-413-4914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 OSLO CIR",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352115965",
            "telephone_number": "205-944-3944",
            "fax_number": "205-413-4914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPENCE DELGADO",
        "first_name": "MARLIESE",
        "name_prefix": "Ms.",
        "credential": "MS, PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-06",
        "last_updated": "2019-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH2643",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "AL",
            "license": "PTH2643",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51037761",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890004070",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.