Active NPI
Marvin Peraza
- Physical Therapy Assistant
- Clinton, MD
National Provider Identifier
1346679628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 2306602569
- Practice address
- 8926 Woodyard Rd Ste 501
Clinton, MD 20735-4234 - Phone
- (571) 216-5477
- NPI assigned
- Nov 6, 2013
- Sex
- Male
- 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 Therapy Assistant | 225200000X | 2306602569 | VA | Primary |
Addresses
Primary practice location
8926 Woodyard Rd Ste 501
Clinton, MD 20735-4234
Mailing address
8926 Woodyard Rd Ste 501
Clinton, MD 20735-4234
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 |
|---|---|---|---|
| 2306602569 | VA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1703116800000",
"number": "1346679628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8926 WOODYARD RD STE 501",
"city": "CLINTON",
"state": "MD",
"postal_code": "207354234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8926 WOODYARD RD STE 501",
"city": "CLINTON",
"state": "MD",
"postal_code": "207354234",
"telephone_number": "571-216-5477"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PERAZA",
"first_name": "MARVIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-11-06",
"last_updated": "2023-12-21",
"certification_date": "2023-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "VA",
"license": "2306602569",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Clinton, MD
- Pediatric Partners of Southern Maryland, PA
- Pediatrix Medical Group of the Mid-Atlantic PC
- Pediatrix of Maryland PA
- Caroline Pembrooke, CRNA
- Brian Quinn Peragine, MD
- Hayda Torres Perdue, M.D
- Moriah Perry, ATC
- Person-Centered Home Care Services LLC
- Angelica Nicolina Ferrazzi Petrous, DNP, APRN, AGPCNP-BC
- Tamika La Cher Phelps
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.