Active NPI
Marie Pelner, PT, DPT
- Physical Therapist
- Redwood City, CA
National Provider Identifier
1447904024
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PTH10726
- Practice address
- 1779 Woodside Rd Ste 102
Redwood City, CA 94061-3461 - Phone
- (650) 780-9700
- NPI assigned
- Feb 11, 2022
- 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 | PTH10726 | AL | Primary |
Addresses
Primary practice location
1779 Woodside Rd Ste 102
Redwood City, CA 94061-3461
Mailing address
16882 Jalisco Ter E
Lakeville, MN 55044-5571
Phone (952) 412-9824
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 |
|---|---|---|---|
| PTH10726 | AL | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644537600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1644537600000",
"number": "1447904024",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16882 JALISCO TER E",
"city": "LAKEVILLE",
"state": "MN",
"postal_code": "550445571",
"telephone_number": "952-412-9824"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1779 WOODSIDE RD STE 102",
"city": "REDWOOD CITY",
"state": "CA",
"postal_code": "940613461",
"telephone_number": "650-780-9700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PELNER",
"first_name": "MARIE",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-02-11",
"last_updated": "2022-02-11",
"certification_date": "2022-01-31",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AL",
"license": "PTH10726",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redwood City, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.