Active NPI
Joydeuz Duque Marquez
- Physical Therapist
- Clinton, IA
National Provider Identifier
1376722751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 004139
- Practice address
- 1377 11TH St NW
Clinton, IA 52732-5068 - Phone
- (563) 241-4230
- NPI assigned
- Nov 1, 2007
- 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 Therapist | 225100000X | 004139 | IA | Primary |
Addresses
Primary practice location
1377 11TH St NW
Clinton, IA 52732-5068
Mailing address
202 N Bluff Blvd Apt 103
Clinton, IA 52732-7159
Phone (561) 716-5760
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 72163 | Other | IA | WELLMARK BLUE CROSS AND BLUE SHIELD |
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 |
|---|---|---|---|
| 004139 | IA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1193875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1216166400000",
"number": "1376722751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "202 N BLUFF BLVD APT 103",
"city": "CLINTON",
"state": "IA",
"postal_code": "527327159",
"telephone_number": "561-716-5760"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1377 11TH ST NW",
"city": "CLINTON",
"state": "IA",
"postal_code": "527325068",
"telephone_number": "563-241-4230"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARQUEZ",
"first_name": "JOYDEUZ",
"middle_name": "DUQUE",
"name_prefix": "Mr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-11-01",
"last_updated": "2008-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IA",
"license": "004139",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK BLUE CROSS AND BLUE SHIELD",
"identifier": "72163",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clinton, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.