Individual provider Active NPI

Marley C Zachmann, DPT

  • Physical Therapist
  • Bismarck, ND
National Provider Identifier
1477964377
Registry record updated Jun 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1749 Issued in ND
Practice address
4204 Boulder Ridge Road, Suite 100
Bismarck, ND 58503
Phone
(701) 751-3064
Fax
(701) 751-2265
NPI assigned
May 13, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X 425-11 ND
Physical Therapist 225100000X 1749 ND Primary

Addresses

Primary practice location

4204 Boulder Ridge Road, Suite 100
Bismarck, ND 58503

Mailing address

4204 Boulder Ridge Road, Suite 100
Bismarck, ND 58503-6162
Phone (701) 751-3064

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ND

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140929001274 ND Practitioner - Physical Therapist in Private Practice 9638399504 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optimum Therapies of North Dakota, IncGroup PAC ID 8628345840, 8 clinicians

Practice addresses (Care Compare)

1040 Canada Ave
Suite 1
Bismarck, ND 58503-1813
Phone (701) 751-3064

Merit-based Incentive Payment System (MIPS)

Final score
85.15 of 100Reported as group
Quality
80.27
Improvement activities
40
Cost
76.81

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1749NDMDAddiction (Substance Use Disorder) Counselor
425-11NDMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Tracie M Mallberg MD PC Past Accepting new patients
Apex Physical Therapy and Wellness Center, PC Physical Therapist Past Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1399939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1477964377",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4204 BOULDER RIDGE ROAD, SUITE 100",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "585036162",
            "telephone_number": "701-751-3064",
            "fax_number": "701-751-2265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4204 BOULDER RIDGE ROAD, SUITE 100",
            "city": "BISMARCK",
            "state": "ND",
            "postal_code": "58503",
            "telephone_number": "701-751-3064",
            "fax_number": "701-751-2265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACHMANN",
        "first_name": "MARLEY",
        "middle_name": "C",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-13",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "ND",
            "license": "425-11",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ND",
            "license": "1749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bismarck, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.