Active NPI
Kimberly Marley
- Physical Therapy Assistant
- Johnstown, PA
National Provider Identifier
1407203953
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- TE009550
- Practice address
- 807 Goucher St
Johnstown, PA 15905-2942 - Phone
- (814) 255-7500
- NPI assigned
- May 14, 2016
- Last updated
- May 14, 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 Therapy Assistant | 225200000X | TE009550 | PA | Primary |
Addresses
Primary practice location
807 Goucher St
Johnstown, PA 15905-2942
Mailing address
45 Gardner St
Johnstown, PA 15905-2553
Phone (814) 255-4965
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 |
|---|---|---|---|
| TE009550 | PA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463184000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463184000000",
"number": "1407203953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "45 GARDNER ST",
"city": "JOHNSTOWN",
"state": "PA",
"postal_code": "159052553",
"telephone_number": "814-255-4965"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "807 GOUCHER ST",
"city": "JOHNSTOWN",
"state": "PA",
"postal_code": "159052942",
"telephone_number": "814-255-7500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARLEY",
"first_name": "KIMBERLY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-05-14",
"last_updated": "2016-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "PA",
"license": "TE009550",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Johnstown, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 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.