Individual provider Active NPI

Marilee Somerville, P.T.

  • Physical Therapist
  • Miller Place, NY
National Provider Identifier
1356577589
Registry record updated Jun 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
007959-1 Issued in NY
Practice address
36 Sweetgum LN
Miller Place, NY 11764
Phone
(631) 474-0416
NPI assigned
Jun 2, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 007959-1 NY Primary

Addresses

Primary practice location

36 Sweetgum LN
Miller Place, NY 11764

Mailing address

36 Sweetgum Lane
Miller Place, NY 11764
Phone (631) 474-0416

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

LicenseStateTypeSpecialty
007959-1NYMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1243900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243900800000",
    "number": "1356577589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 SWEETGUM LANE",
            "city": "MILLER PLACE",
            "state": "NY",
            "postal_code": "11764",
            "telephone_number": "631-474-0416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 SWEETGUM LN",
            "city": "MILLER PLACE",
            "state": "NY",
            "postal_code": "11764",
            "telephone_number": "631-474-0416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOMERVILLE",
        "first_name": "MARILEE",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-02",
        "last_updated": "2009-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "007959-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miller Place, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2009; 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.