Active NPI
Marissa Carlyon
- Physical Therapist
- Junction City, KS
National Provider Identifier
1376909044
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 11-05089
- Practice address
- 1102 Saint Marys Rd
Junction City, KS 66441 - Phone
- (785) 762-3350
- Fax
- (785) 762-3920
- NPI assigned
- Jan 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 | 11-05089 | KS | Primary |
Addresses
Primary practice location
1102 Saint Marys Rd
Junction City, KS 66441
Mailing address
2812 W 12TH Ave
Emporia, KS 66801-6202
Phone (620) 208-7878
Other practice location 1
104 S. Washington St.
Junction City, KS 66441
Phone (785) 238-3747
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1452470400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631577600000",
"number": "1376909044",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2812 W 12TH AVE",
"city": "EMPORIA",
"state": "KS",
"postal_code": "668016202",
"telephone_number": "620-208-7878",
"fax_number": "620-208-7000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1102 SAINT MARYS RD",
"city": "JUNCTION CITY",
"state": "KS",
"postal_code": "66441",
"telephone_number": "785-762-3350",
"fax_number": "785-762-3920"
}
],
"practiceLocations": [
{
"address_1": "104 S. Washington St.",
"address_purpose": "LOCATION",
"city": "Junction City",
"state": "KS",
"postal_code": "66441",
"country_code": "US",
"telephone_number": "785-238-3747",
"fax_number": "785-238-5514",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CARLYON",
"first_name": "MARISSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-01-11",
"last_updated": "2021-09-14",
"certification_date": "2021-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "KS",
"license": "11-05089",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Junction City, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.