Individual provider Active NPI

Emily Morgan Marriott

  • Physical Therapy Assistant
  • Rexburg, ID
National Provider Identifier
1487199295
Registry record updated Jan 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA-4834 Issued in ID
Practice address
36 Winn Dr Ste 100
Rexburg, ID 83440-5277
Phone
(208) 356-0174
Fax
(208) 356-0176
NPI assigned
Jan 3, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2017

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 PTA-4834 ID Primary

Addresses

Primary practice location

36 Winn Dr Ste 100
Rexburg, ID 83440-5277

Mailing address

66 S 1St W
Rexburg, ID 83440-1815
Phone (253) 508-9472

Other names 1

  • Emily Morgan Marriott Former name

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
PTA-4834IDMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
PMD Therapies, PLLC PastSince May 2, 2005 Accepting new patients
Mountain View Hospital LLC 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1483401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483401600000",
    "number": "1487199295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 S 1ST W",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834401815",
            "telephone_number": "253-508-9472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "36 WINN DR STE 100",
            "city": "REXBURG",
            "state": "ID",
            "postal_code": "834405277",
            "telephone_number": "208-356-0174",
            "fax_number": "208-356-0176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARRIOTT",
        "first_name": "EMILY",
        "middle_name": "MORGAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-03",
        "last_updated": "2017-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "ID",
            "license": "PTA-4834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "MARRIOTT",
            "middle_name": "MORGAN",
            "credential": "PTA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rexburg, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2017; 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.