Individual provider Active NPI

Marilyn Gleeson, PTA

  • Physical Therapy Assistant
  • Staunton, VA
National Provider Identifier
1477096618
Registry record updated Nov 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
2306001251 Issued in VA
Practice address
542 Walnut Hills Rd
Staunton, VA 24401-6935
Phone
(540) 337-1999
Fax
(540) 337-9618
NPI assigned
Nov 21, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2016

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 2306001251 VA Primary

Addresses

Primary practice location

542 Walnut Hills Rd
Staunton, VA 24401-6935

Mailing address

542 Walnut Hills Rd
Staunton, VA 24401-6935
Phone (540) 337-1999

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
2306001251VAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1479686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479686400000",
    "number": "1477096618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "542 WALNUT HILLS RD",
            "city": "STAUNTON",
            "state": "VA",
            "postal_code": "244016935",
            "telephone_number": "540-337-1999",
            "fax_number": "540-337-9618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "542 WALNUT HILLS RD",
            "city": "STAUNTON",
            "state": "VA",
            "postal_code": "244016935",
            "telephone_number": "540-337-1999",
            "fax_number": "540-337-9618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLEESON",
        "first_name": "MARILYN",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-11-21",
        "last_updated": "2016-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "VA",
            "license": "2306001251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staunton, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2016; 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.