Active NPI
Jerry Marsh
- Physical Therapist
- Newport, OR
National Provider Identifier
1275993123
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 6116
- Practice address
- 835 SW 11TH St
Newport, OR 97365-4802 - Phone
- (541) 265-5356
- NPI assigned
- Mar 3, 2016
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 6116 | OR | Primary |
| Physical Therapist | 225100000X | 2253 | AZ |
Addresses
Primary practice location
835 SW 11TH St
Newport, OR 97365-4802
Mailing address
835 SW 11TH St
Newport, OR 97365-4802
Phone (541) 265-5356
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 |
|---|---|---|---|
| 2253 | AZ | MD | Physical Therapist |
| 6116 | OR | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1456963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456963200000",
"number": "1275993123",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "835 SW 11TH ST",
"city": "NEWPORT",
"state": "OR",
"postal_code": "973654802",
"telephone_number": "541-265-5356"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "835 SW 11TH ST",
"city": "NEWPORT",
"state": "OR",
"postal_code": "973654802",
"telephone_number": "541-265-5356"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARSH",
"first_name": "JERRY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-03-03",
"last_updated": "2016-03-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OR",
"license": "6116",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AZ",
"license": "2253",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Newport, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.