Individual provider Active NPI

Marlon Lim, PT

  • Physical Therapist
  • Roanoke Rapids, NC
National Provider Identifier
1467673632
Registry record updated Apr 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8735 Issued in NC
Practice address
1223 Julian R Allsbrook Hwy
Roanoke Rapids, NC 27870-5126
Phone
(252) 537-1215
Fax
(252) 537-1816
NPI assigned
May 2, 2007
Last updated
Apr 16, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 8735 NC Primary

Addresses

Primary practice location

1223 Julian R Allsbrook Hwy
Roanoke Rapids, NC 27870-5126

Mailing address

PO Box 7594
Rocky Mount, NC 27804-0594
Phone (252) 443-0808

Other identifiers 4

IdentifierTypeStateIssuer
2504211OtherNCMEDICARE - CPTA
2504211AOtherNCMEDICARE - WOSNC
078UWOtherBCBS
7212481MedicaidNC

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

LicenseStateTypeSpecialty
8735NCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Physical Therapy Associates LLC Past Accepting new patients
Wilson Orthopaedic Surgery & Neurology Center PA Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1239840000000",
    "number": "1467673632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7594",
            "city": "ROCKY MOUNT",
            "state": "NC",
            "postal_code": "278040594",
            "telephone_number": "252-443-0808",
            "fax_number": "252-451-9032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1223 JULIAN R ALLSBROOK HWY",
            "city": "ROANOKE RAPIDS",
            "state": "NC",
            "postal_code": "278705126",
            "telephone_number": "252-537-1215",
            "fax_number": "252-537-1816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIM",
        "first_name": "MARLON",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-02",
        "last_updated": "2009-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "8735",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE - CPTA",
            "identifier": "2504211",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE - WOSNC",
            "identifier": "2504211A",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "078UW",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7212481",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roanoke Rapids, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2009; 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.