Individual provider Active NPI

Marib Boyea Iley, LPTA

  • Physical Therapy Assistant
  • San Antonio, TX
National Provider Identifier
1457657520
Registry record updated Feb 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2072750 Issued in TX
Practice address
1020 Central Pkwy S
San Antonio, TX 78232-5021
Phone
(210) 798-2273
NPI assigned
Feb 7, 2011
Last updated
Feb 7, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2011

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 2072750 TX Primary

Addresses

Primary practice location

1020 Central Pkwy S
San Antonio, TX 78232-5021

Mailing address

13000 Vista del Norte
Apartment 1023
San Antonio, TX 78216-8038
Phone (361) 449-6330

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
2072750TXMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1297036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297036800000",
    "number": "1457657520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13000 VISTA DEL NORTE",
            "address_2": "APARTMENT 1023",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782168038",
            "telephone_number": "361-449-6330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 CENTRAL PKWY S",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782325021",
            "telephone_number": "210-798-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILEY",
        "first_name": "MARIB",
        "middle_name": "BOYEA",
        "name_prefix": "Ms.",
        "credential": "LPTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-02-07",
        "last_updated": "2011-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2072750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

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

Verify at the official NPI Registry.