Individual provider Active NPI

Maria Martanovic

  • Physical Therapy Assistant
  • Gahanna, OH
National Provider Identifier
1407336308
Registry record updated Aug 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
05114 Issued in OH
Practice address
765 N Hamilton Rd
Gahanna, OH 43230-8703
Phone
(614) 563-1609
Fax
(614) 566-0515
NPI assigned
Aug 20, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 05114 OH Primary

Addresses

Primary practice location

765 N Hamilton Rd
Gahanna, OH 43230-8703

Mailing address

765 N Hamilton Rd
Gahanna, OH 43230-8703
Phone (614) 566-0505

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
05114OHMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1534723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534723200000",
    "number": "1407336308",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "765 N HAMILTON RD",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432308703",
            "telephone_number": "614-566-0505",
            "fax_number": "614-566-0515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 N HAMILTON RD",
            "city": "GAHANNA",
            "state": "OH",
            "postal_code": "432308703",
            "telephone_number": "614-563-1609",
            "fax_number": "614-566-0515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTANOVIC",
        "first_name": "MARIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-20",
        "last_updated": "2018-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OH",
            "license": "05114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gahanna, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2018; 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.