Active NPI
Marwyn Garibay Benemerito, OTR/L
- Occupational Therapist
- Cordova, TN
National Provider Identifier
1295834752
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 955
- Practice address
- 895 Willow Tree Cir
Suite 100
Cordova, TN 38018-3106 - Phone
- (901) 309-5219
- Fax
- (901) 309-5265
- NPI assigned
- Sep 21, 2006
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 955 | TN | Primary |
Addresses
Primary practice location
895 Willow Tree Cir
Suite 100
Cordova, TN 38018-3106
Mailing address
895 Willow Tree Cir
Suite 100
Cordova, TN 38018-3106
Phone (901) 309-5219
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4128796 | Other | TN | BCBS OF TN PIN |
| 4290875 | Other | TN | BCBS PIN |
| 7536487 | Other | TN | AETNA PIN |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Therapy Hut, Inc. | Occupational Therapist | Past | Accepting new patients |
| Team Autism Memphis | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Occupational Therapist
- Cordova, TN
- NPI 1942591821
-
- Developmental Disabilities Clinic/Center
- Memphis, TN
- NPI 1609223163
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158796800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1408924800000",
"number": "1295834752",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "895 WILLOW TREE CIR",
"address_2": "SUITE 100",
"city": "CORDOVA",
"state": "TN",
"postal_code": "380183106",
"telephone_number": "901-309-5219",
"fax_number": "901-309-5265"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "895 WILLOW TREE CIR",
"address_2": "SUITE 100",
"city": "CORDOVA",
"state": "TN",
"postal_code": "380183106",
"telephone_number": "901-309-5219",
"fax_number": "901-309-5265"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENEMERITO",
"first_name": "MARWYN",
"middle_name": "GARIBAY",
"name_prefix": "Mr.",
"credential": "OTR/L",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-21",
"last_updated": "2014-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "TN",
"license": "955",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF TN PIN",
"identifier": "4128796",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PIN",
"identifier": "4290875",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA PIN",
"identifier": "7536487",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cordova, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.