Active NPI
Kimberly Suzanne Marks, PT, DPT
- Physical Therapist
- Long Beach, CA
National Provider Identifier
1306292198
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT291314
- Practice address
- 3294 E Spring St
Long Beach, CA 90806-2426 - Phone
- (562) 988-3571
- Fax
- (562) 988-3671
- NPI assigned
- May 11, 2016
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT291314 | CA | Primary |
Addresses
Primary practice location
3294 E Spring St
Long Beach, CA 90806-2426
Mailing address
575 Addison Ave
Palo Alto, CA 94301-3204
Phone (650) 815-8501
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT291314 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1462924800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1462924800000",
"number": "1306292198",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "575 ADDISON AVE",
"city": "PALO ALTO",
"state": "CA",
"postal_code": "943013204",
"telephone_number": "650-815-8501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3294 E SPRING ST",
"city": "LONG BEACH",
"state": "CA",
"postal_code": "908062426",
"telephone_number": "562-988-3571",
"fax_number": "562-988-3671"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARKS",
"first_name": "KIMBERLY",
"middle_name": "SUZANNE",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-11",
"last_updated": "2016-05-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CA",
"license": "PT291314",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.