Active NPI
Nicole Marie Marks, MSPT
- Physical Therapist
- Watertown, NY
National Provider Identifier
1427339241
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 019243-1
- Practice address
- 20104 State Route 3
Programs for Exceptional Students
Watertown, NY 13601-5560 - Phone
- (315) 779-7100
- NPI assigned
- Sep 7, 2011
- Last updated
- Sep 7, 2011
- 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 | 019243-1 | NY | Primary |
Addresses
Primary practice location
20104 State Route 3
Programs for Exceptional Students
Watertown, NY 13601-5560
Mailing address
20104 State Route 3
Programs for Exceptional Students
Watertown, NY 13601-5560
Phone (315) 779-7100
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 |
|---|---|---|---|
| 019243-1 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1315353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1315353600000",
"number": "1427339241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20104 STATE ROUTE 3",
"address_2": "PROGRAMS FOR EXCEPTIONAL STUDENTS",
"city": "WATERTOWN",
"state": "NY",
"postal_code": "136015560",
"telephone_number": "315-779-7100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20104 STATE ROUTE 3",
"address_2": "PROGRAMS FOR EXCEPTIONAL STUDENTS",
"city": "WATERTOWN",
"state": "NY",
"postal_code": "136015560",
"telephone_number": "315-779-7100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARKS",
"first_name": "NICOLE",
"middle_name": "MARIE",
"name_prefix": "Mrs.",
"credential": "MSPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-07",
"last_updated": "2011-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "019243-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Watertown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.